Individual
MATTHEW WITHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
2430 NICOLLET AVE, MINNEAPOLIS, MN 55404-3461
(612) 871-1454
(612) 871-1505
Mailing address
2430 NICOLLET AVE, MINNEAPOLIS, MN 55404-3461
(612) 871-1454
(612) 871-1505
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1826
MN
Other
Enumeration date
12/22/2008
Last updated
12/22/2008
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