Individual
ANN BODENSTEINER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA LP
Contact information
Practice address
11010 PRAIRIE LAKES DRIVE, SUITE 350, EDEN PRAIRIE, MN 55344
(952) 746-2522
Mailing address
1900 SILVER LAKE ROAD NW, SUITE 110, NEW BRIGHTON, MN 55112
(651) 379-1764
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP3829
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
439281700
—
MN
01
—
454S8BO
MN BCBS
MN
01
—
HP40196
HEALTH PARTNERS
MN
Enumeration date
09/25/2006
Last updated
02/28/2017
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