Individual
DR. MINDY SUE BENOWITZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
2908 HUMBOLDT AVE S, MINNEAPOLIS, MN 55408-1953
(612) 870-0398
(612) 822-2766
Mailing address
2908 HUMBOLDT AVE S, MINNEAPOLIS, MN 55408-1953
(612) 870-0398
(612) 822-2766
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP1193
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3K446BE
BLUE CROSS BLUE SHIELD MN
MN
05
—
855350500
—
MN
Enumeration date
12/05/2006
Last updated
07/19/2017
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