Provider Demographics
NPI:1821049719
Name:BOHN, DENA (PSYD, LP)
Entity Type:Individual
Prefix:
First Name:DENA
Middle Name:
Last Name:BOHN
Suffix:
Gender:F
Credentials:PSYD, LP
Other - Prefix:
Other - First Name:DENA
Other - Middle Name:BOHN
Other - Last Name:HESCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3503 HIGHPOINT DR N STE 230
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55128-7577
Mailing Address - Country:US
Mailing Address - Phone:651-373-0280
Mailing Address - Fax:651-203-3504
Practice Address - Street 1:3503 HIGHPOINT DR N STE 230
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:MN
Practice Address - Zip Code:55128-7577
Practice Address - Country:US
Practice Address - Phone:651-373-0280
Practice Address - Fax:651-203-3504
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-15
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3257103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN393016500Medicaid
MN471R7B0OtherBLUE CROSS
MN984241043572OtherPREFERRED ONE