Provider Demographics
NPI:1316314917
Name:BENSON-HANCE, DAWN
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:BENSON-HANCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 1ST ST N STE 101
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-1924
Mailing Address - Country:US
Mailing Address - Phone:320-257-4230
Mailing Address - Fax:320-251-4175
Practice Address - Street 1:3400 1ST ST N STE 101
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-1924
Practice Address - Country:US
Practice Address - Phone:320-257-4230
Practice Address - Fax:320-251-4175
Is Sole Proprietor?:No
Enumeration Date:2015-08-31
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN01034101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional