Provider Demographics
NPI:1023034980
Name:BENSON, BARBARA I (RD)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:I
Last Name:BENSON
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:
Other - Last Name:INGRASSIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:3828 HUNTINGDON DR
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55305-5115
Mailing Address - Country:US
Mailing Address - Phone:952-933-2396
Mailing Address - Fax:
Practice Address - Street 1:14500 99TH AVE N
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-4478
Practice Address - Country:US
Practice Address - Phone:763-898-1073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1019133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered