Individual
MS. BEVERLY JEAN CARUSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICENSED INDEPENDENT
Contact information
Practice address
2829 INGLEWOOD AVE S, ST LOUIS PARK, MN 55416-4111
(952) 920-6568
(952) 920-5891
Mailing address
2829 INGLEWOOD AVE SOUTH, ST LOUIS PARK, MN 55416-4111
(952) 920-6568
(952) 920-5891
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
00479
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00469
LICENSE SOCIAL WORKER
MN
Enumeration date
08/23/2006
Last updated
07/08/2007
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