Individual
ANDREA BENO
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
314 MAIN ST E, SUITE 3, NEW PRAGUE, MN 56071-2448
(952) 758-5775
(952) 758-5778
Mailing address
8830 NORMANDALE BLVD, BLOOMINGTON, MN 55437-1051
(952) 758-5775
(952) 758-5778
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
102007
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
685S7MA
MN BCBS NUMBER
MN
01
—
7616187
MN AETNA NUMBER
MN
01
—
HP43201
MN HEALTHPARTNERS NUMBER
FM
Enumeration date
02/06/2006
Last updated
07/09/2007
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