Andrea L Benjamin Malp LTD
Organization Active NPI Psychologist · Waconia, MN
NPI 1689666349 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1689666349
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychologist 103T00000X
- License
- LP2926 (MN)
- Legal business name
- ANDREA L BENJAMIN MALP LTD
- Practice address
- 137 W 1St St
Waconia, MN 55387-1190 - Phone
- (952) 442-5005
- Fax
- (952) 442-7586
- NPI assigned
- Aug 18, 2005
- Organization subpart
- No
Authorized official
- Name
- Andrea L Benjamin, MALP
- Title
- Psycologist
- Phone
- (952) 442-5005
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist |
103T00000X | LP2926 | MN | Yes |
Addresses
Primary practice location
137 W 1St St
Waconia, MN 55387-1190
Mailing address
137 W 1St St
Waconia, MN 55387-1190
Phone (952) 442-5005
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7H308BE | Other | MN | BCBS |
Other providers in Waconia, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.