Individual
PAULA ANN BEISWENGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1246 UNIVERSITY AVE W, SAINT PAUL, MN 55104-4125
(651) 603-8774
Mailing address
1246 UNIVERSITY AVE W, SAINT PAUL, MN 55104-4125
(651) 603-8774
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
100514
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02S70BE
BLUE CROSS PROVIDER #
MN
Enumeration date
10/15/2007
Last updated
10/15/2007
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