Provider Demographics
NPI:1609973874
Name:BEYER, PAMELA J (PSYD, LP)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:J
Last Name:BEYER
Suffix:
Gender:F
Credentials:PSYD, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 HIGHWAY 13 E
Mailing Address - Street 2:STE. 101
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-6865
Mailing Address - Country:US
Mailing Address - Phone:952-895-9200
Mailing Address - Fax:952-895-1946
Practice Address - Street 1:1601 HIGHWAY 13 E
Practice Address - Street 2:STE. 101
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-6865
Practice Address - Country:US
Practice Address - Phone:952-895-9200
Practice Address - Fax:952-895-1946
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP0391103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical