Hertle, Amy Beth

Hertle, Amy Beth is an sole proprietor health care provider with primary practice located at 3570 Lexington Ave N Suite 100, Shoreview MN 55126-8049. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Hertle, Amy Beth can be contacted via phone (651) 481-0664.

Contact Information

Primary practice address
3570 Lexington Ave N Suite 100 Shoreview MN 55126-8049
Phone: (651) 481-0664
Fax: (651) 481-3907
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 14904 Minnesota

Profile Details

NPI number 1376605808
LBN Legal business name Hertle, Amy Beth
Credentials L.I.C.S.W., L.P.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 14th, 2006
Last updated Sep 8th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376605808 NPPES
Minnesota MEDICAID 968115900
Minnesota Other HP57337

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