Individual
MATTHEW RUPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
1900 SILVER LAKE ROAD NW, SUITE 110, NEW BRIGHTON, MN 55112
(651) 379-1718
(651) 379-1738
Mailing address
1900 SILVER LAKE ROAD NW, SUITE 110, NEW BRIGHTON, MN 55112
(651) 379-1718
(651) 379-1738
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
304594
MN
Other
Enumeration date
09/02/2016
Last updated
09/23/2016
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