Individual
SHIROMI BEACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPCC
Contact information
Practice address
6363 FRANCE AVE S, EDINA, MN 55435-2129
(952) 230-9100
Mailing address
8500 5TH AVE S, BLOOMINGTON, MN 55420-2334
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LPC 1443
MN
101YM0800X
Mental Health Counselor
Primary
LPCC 883
MN
Other
Enumeration date
11/03/2014
Last updated
09/26/2018
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