Provider Demographics
NPI:1063885051
Name:BEA, EMILY ANNE CIERZAN
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:ANNE CIERZAN
Last Name:BEA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5200 WILLSON RD STE 215&445
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55424-1332
Mailing Address - Country:US
Mailing Address - Phone:612-787-2344
Mailing Address - Fax:952-426-3250
Practice Address - Street 1:5200 WILLSON RD STE 215&445
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55424-1332
Practice Address - Country:US
Practice Address - Phone:612-787-2344
Practice Address - Fax:952-426-3250
Is Sole Proprietor?:No
Enumeration Date:2015-11-12
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst