Individual
DIANNE RANAE BERG
Active
Individual
DIANNE RANAE BERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
LP4299
MN
103TC0700X
Clinical Psychologist
Primary
LP4299
MN
106H00000X
Marriage & Family Therapist
LMFT 0487
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
307193600
—
MN
01
—
984151027400
PREFERREDONE
MN
01
—
HP48975
HEALTHPARTNERS
MN
Enumeration date
10/25/2006
Last updated
07/07/2008
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