Provider Demographics
NPI:1790984227
Name:BENSON, SONJA (PHD)
Entity Type:Individual
Prefix:DR
First Name:SONJA
Middle Name:
Last Name:BENSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 TWELVE OAKS CENTER DR
Mailing Address - Street 2:SUITE 219
Mailing Address - City:WAYZATA
Mailing Address - State:MN
Mailing Address - Zip Code:55391-4501
Mailing Address - Country:US
Mailing Address - Phone:952-232-7011
Mailing Address - Fax:952-495-8090
Practice Address - Street 1:600 TWELVE OAKS CENTER DR
Practice Address - Street 2:SUITE 219
Practice Address - City:WAYZATA
Practice Address - State:MN
Practice Address - Zip Code:55391-4501
Practice Address - Country:US
Practice Address - Phone:952-232-7011
Practice Address - Fax:952-495-8090
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-14
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3252103TC1900X, 103TF0000X
MNLP 5311103TC1900X, 103TF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily