Individual
DAVID J MATHEWS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
1930 COON RAPIDS BLVD NW, COON RAPIDS, MN 55433-4708
(763) 427-7964
(763) 427-7976
Mailing address
2060 CENTRE POINTE BLVD STE 3, SAINT PAUL, MN 55120-1271
(612) 279-1033
(651) 774-0606
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
8113
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093815136
—
MN
Enumeration date
09/25/2006
Last updated
04/12/2018
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