Individual
BENNETT BRANDVOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW, LGSW
Contact information
Practice address
4900 HIGHWAY 169 N STE 220, NEW HOPE, MN 55428-4058
(612) 517-1577
Mailing address
4900 HIGHWAY 169 N STE 220, NEW HOPE, MN 55428-4058
(612) 517-1577
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
28626
MN
Other
Enumeration date
06/07/2022
Last updated
06/07/2022
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