Individual
DR. MATTHEW KINGSBURY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD, LP
Contact information
Practice address
11316 86TH AVE N, MAPLE GROVE, MN 55369-4528
(763) 400-8000
(763) 400-8000
Mailing address
11316 86TH AVE N, MAPLE GROVE, MN 55369-4528
(763) 400-8000
(651) 426-8116
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP6684
MN
Other
Enumeration date
12/08/2014
Last updated
07/12/2022
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