Provider Demographics
NPI:1851067466
Name:BENSON, PAIGE MARIE
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:MARIE
Last Name:BENSON
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 1:302 PAINE FARM RD
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55804-2632
Mailing Address - Country:US
Mailing Address - Phone:218-340-0657
Mailing Address - Fax:
Practice Address - Street 1:324 W SUPERIOR ST STE 620
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55802-1723
Practice Address - Country:US
Practice Address - Phone:218-606-1797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-23
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional