Individual
MELISSA BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LGSW
Contact information
Practice address
7601 WAYZATA BLVD, ST LOUIS PARK, MN 55426-1623
(612) 223-8898
Mailing address
1172 HIGHVIEW DR, NEW BRIGHTON, MN 55112-2417
(507) 210-6959
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/09/2023
Last updated
12/18/2023
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