Most Relevant Information
Provider Data
| NPI Number: | 1003029265 |
| Provider Name: | CATHLEEN BENGTSON MA, LP |
| Entity Type: | Individual |
| Taxonomy Code: | 103TC0700X |
| Specialty: | Psychologist |
| License Number: | LP2096 |
Most Important Dates
| Enumeration Date: | 05/07/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
215 SE 2ND AVE
GRAND RAPIDS
MN
557443615
Practice Location Phone/Fax
| Phone: | 2183261274 |
| Fax: |
Provider Mailing Location
215 SE 2ND AVE
GRAND RAPIDS
MN
557443615
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |