Individual
MS. DOLORES JANE MATTHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
23 4TH STREET SE, #202, MINNEAPOLIS, MN 55414-1090
(612) 379-8050
(612) 379-8069
Mailing address
23 4TH STREET SE, #202, MINNEAPOLIS, MN 55414-1090
(612) 379-8050
(612) 379-8069
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2240
MN
103TC1900X
Counseling Psychologist
2240
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10946MA
BCBS
—
01
—
1581490
MEDICA
—
Enumeration date
01/31/2008
Last updated
01/31/2008
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