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Individual

MR. BENJAMIN J WOLF

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LICSW

Contact information

Practice address
13750 CROSSTOWN DR NW, SUITE L101, ANDOVER, MN 55304-5853
(763) 482-9598
Mailing address
11105 ZEBULON PIKE AVE, BURNSVILLE, MN 55337-1151
(612) 802-9398

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
16965
MN

Other

Enumeration date
05/25/2007
Last updated
07/08/2007
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