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Individual

BEVERLY WENTWORTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LAMFT

Contact information

Practice address
1935 COUNTY ROAD B2 W STE 120, ROSEVILLE, MN 55113-2722
(651) 253-4050
(651) 426-3283
Mailing address
4132 JAY LN, WHITE BEAR LAKE, MN 55110-7407
(651) 253-4050
(651) 426-3283

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
2934
MN

Other

Enumeration date
10/03/2014
Last updated
10/03/2014
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