Individual
MRS. BETH W MATTHEWS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
15600 53RD AVE N, PLYMOUTH, MN 55446
(763) 489-8430
(855) 213-0734
Mailing address
15600 53RD AVE N, PLYMOUTH, MN 55446
(763) 489-8430
(855) 213-0734
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
24589
MN
1041C0700X
Clinical Social Worker
34003697A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24589
LISCW
MN
Enumeration date
11/17/2006
Last updated
12/07/2020
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