Individual
GAIL MATTOCKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
713 ANDERSON AVE, SAINT CLOUD, MN 56303-2048
(320) 229-3760
(320) 229-3764
Mailing address
1406 6TH AVE N, SAINT CLOUD, MN 56303-1900
(320) 251-2700
(320) 656-7009
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
302584
MN
Other
Enumeration date
02/12/2018
Last updated
02/12/2018
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