Individual
DR. THOMAS T BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD, LP
Contact information
Practice address
3800 PARK NICOLLET BLVD, ST LOUIS PARK, MN 55416-2527
(952) 993-2498
Mailing address
8170 33RD AVE S, MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP4251
MN
Other
Enumeration date
12/27/2005
Last updated
12/12/2016
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