Beverly Jean Long

NPI #1588819551 in Saint Paul, Minnesota

Provider Information

NPI Number: 1588819551
Entity Type: Organization
Organization Name: Beverly Jean Long
Primary Specialty: Psychologist
Enumeration Date: Nov 18, 2008
Last Updated: Nov 18, 2008

Practice Location

Address: 1595 SELBY AVE
Address 2: SUITE 202
City: Saint Paul
State: Minnesota
ZIP Code: 55104-6221
Phone: (651) 253-8438

Authorized Official

Name: MRS. JANET MARIE MEULEMANS
Title: ADMINISTRATIVE ASSISTANT/BILLER
Phone: (651) 307-7865

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist	103T00000X	Primary

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