Individual
DR. JANE ANN BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LP
Contact information
Practice address
314 CLIFTON AVE STE 201, MINNEAPOLIS, MN 55403-3385
(612) 750-7219
Mailing address
314 CLIFTON AVE STE 201, MINNEAPOLIS, MN 55403-3385
(612) 750-7219
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
4151
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
474128500
—
MN
Enumeration date
08/31/2006
Last updated
07/24/2019
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