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Individual

DIANA BERAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, LP

Contact information

Practice address
2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454-1450
(612) 672-6999
(612) 672-2691
Mailing address
506 WILLOWMERE DR, ZUMBROTA, MN 55992-1297

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP3979
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
112M2BE
BCBS
MN
01
129786
UCARE
MN
01
170155000
MN CARE
MN
01
41-1546550
BHP
MN
01
62-41762
UBH
MN
01
HP30456
HEALTHPARTNERS
MN
Enumeration date
10/03/2006
Last updated
02/13/2012
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