Individual
JENNIFER BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S., L.P.
Contact information
Practice address
11900 WAYZATA BLVD, SUITE 214, MINNETONKA, MN 55305-2031
(952) 446-7933
Mailing address
11900 WAYZATA BLVD, SUITE 214, MINNETONKA, MN 55305-2031
(952) 446-7933
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP3253
MN
Other
Enumeration date
01/29/2013
Last updated
01/29/2013
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