Individual
DR. BRADLEY S BENGTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
33 VILLAGE PKWY, SUITE 109, LINO LAKES, MN 55014-4409
(612) 644-2502
Mailing address
33 VILLAGE PKWY, SUITE 109, LINO LAKES, MN 55014-4409
(612) 644-2502
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
LP4712
MN
Other
Enumeration date
03/10/2011
Last updated
03/10/2011
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