Individual
SHAWNA MARIE BENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY. D., LP
Contact information
Practice address
11116 ZEALAND AVE N, SOUL WORK COUNSELING #117, CHAMPLIN, MN 55316
(763) 746-0842
(763) 746-0843
Mailing address
11116 ZEALAND AVE N, # 117, CHAMPLIN, MN 55316-3594
(763) 746-0842
(763) 220-6025
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP4564
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
933103400
—
MN
Enumeration date
09/26/2006
Last updated
06/17/2020
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