Individual
MARY BENY BECERRIL-GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LAT, ATC
Contact information
Practice address
2211 RIVERSIDE AVE, MINNEAPOLIS, MN 55454-1350
(612) 330-1008
Mailing address
15430 FOUNDERS LN APT 234, APPLE VALLEY, MN 55124-6182
(952) 380-6196
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
3401
MN
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
MN
Other
Enumeration date
01/12/2020
Last updated
12/13/2021
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