Individual
MATTHEW WATNEMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCC
Contact information
Practice address
6776 LAKE DR STE 170, LINO LAKES, MN 55014-1201
(651) 356-8741
Mailing address
21000 ROGERS DR STE 200, ROGERS, MN 55374-4926
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4590
MN
Other
Enumeration date
09/16/2024
Last updated
09/16/2024
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