Individual
DIANNE RANAE BERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1300 S 2ND ST, SUITE 180, MINNEAPOLIS, MN 55454-1075
(612) 625-1500
Mailing address
3989 CENTRAL AVE NE, SUITE 180, COLUMBIA HEIGHTS, MN 55421-3900
(612) 625-1500
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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