Individual
TYLER BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
41385 US HIGHWAY 71, WINDOM, MN 56101-3197
(507) 831-2090
Mailing address
PO BOX 353, WINDOM, MN 56101-0353
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CC01570
MN
Other
Enumeration date
08/01/2017
Last updated
03/17/2018
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