Individual
BENNETT JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.I.C.S.W.
Contact information
Practice address
13750 CROSSTOWN DR NW, MOLLY PROFESSIONAL CENTER, PHASE II, #207, ANDOVER, MN 55304-5853
(763) 755-6290
Mailing address
13750 CROSSTOWN DR NW, STE 207, ANDOVER, MN 55304-5856
(763) 755-6290
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
21840
MN
Other
Enumeration date
02/19/2016
Last updated
04/08/2016
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