Individual
BENJAMIN DIEFFENBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW, LICSW
Contact information
Practice address
2368 JOY AVE, WHITE BEAR LAKE, MN 55110-7409
(651) 338-9435
Mailing address
2368 JOY AVE, WHITE BEAR LAKE, MN 55110-7409
(651) 338-9435
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
22483
MN
Other
Enumeration date
05/18/2016
Last updated
03/04/2024
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