Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | ||
N | 101YS0200X | School Counselor |
NPI | 1093399586 |
---|---|
Provider Name | Stephanie Bender |
First Address | Minneapolis, MN 55419-2001 |
Second Address | St Louis Park, MN 55416-1653 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2021 |
Last Update Date | 10/05/2021 |