Individual
KAITLYN ELIZABETH BENZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW, LADC
Contact information
Practice address
210 GATEWAY DR NE STE 4, EAST GRAND FORKS, MN 56721-1621
(218) 230-0787
Mailing address
6801 MARLOWE AVE NE, OTSEGO, MN 55330-7435
(612) 816-5019
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
305848
MN
104100000X
Social Worker
28796
MN
1041C0700X
Clinical Social Worker
Primary
28796
MN
Other
Enumeration date
11/09/2020
Last updated
06/07/2024
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