Individual
DR. IRVING BENOIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD LP
Contact information
Practice address
430 OAK GROVE ST, SUITE 216, MINNEAPOLIS, MN 55403
(612) 870-1787
Mailing address
4104 HARRIET AV SO, MINNEAPOLIS, MN 55409-1443
(612) 823-8715
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP1909
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01192BE
BCBS MN
—
Enumeration date
04/26/2007
Last updated
07/08/2007
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