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Individual

MATTHEW DANIEL WALFOORT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
BA , LADC

Contact information

Practice address
1246 UNIVERSITY AVE W, SAINT PAUL, MN 55104-4125
(651) 204-0226
(651) 383-4537
Mailing address
1246 UNIVERSITY AVE W, SAINT PAUL, MN 55104-4125
(651) 204-0226
(651) 383-4537

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
304592
MN

Other

Enumeration date
11/24/2020
Last updated
11/24/2020
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