Doctor Name: | MS. MELODEE JEAN BENSON |
NPI Number: | 1013200856 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LADC |
License Number: | 303035 |
Business Practice Address: | 135 Colorado St E Saint Paul, MN - 551072244 |
Business Phone Number: | 6514897740 |
Business Fax Number: | 6514896458 |
Mailing Address: | 840 3rd St E, SAINT PAUL |
State: | MN |
Postal Code: | 551065141 |
Phone Number: | 6122197187 |
Fax Number: | 6514896458 |
NPI Enumeration Date: | 05/26/2011 |
NPI Last Update Date: | 05/26/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 303035 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |