Organization
ANDREA L BENJAMIN MALP LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA L BENJAMIN MALP (PSYCOLOGIST)
(952) 442-5005
Entity
Organization
Contact information
Practice address
137 W 1ST ST, WACONIA, MN 55387-1190
(952) 442-5005
(952) 442-7586
Mailing address
137 W 1ST ST, WACONIA, MN 55387-1190
(952) 442-5005
(952) 442-7586
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP2926
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7H308BE
BCBS
MN
Enumeration date
08/18/2005
Last updated
08/22/2020
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