Individual
DR. STACEY L BENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY D
Contact information
Practice address
2624 9TH AVE S, FARGO, ND 58103-2350
(701) 298-4500
(701) 298-4400
Mailing address
2624 9TH AVE S, FARGO, ND 58103-2350
(701) 298-4500
(701) 298-4400
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
ND 327
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
026706
BCBS OF ND PIN
ND
Enumeration date
07/11/2006
Last updated
07/08/2007
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