Individual
CHERYL KAY MATASCASTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.M.F.T.
Contact information
Practice address
2277 HIGHWAY 36 W STE 150, ROSEVILLE, MN 55113-3830
(507) 345-4769
(952) 435-6797
Mailing address
11 CIVIC CENTER PLZ STE 205, MANKATO, MN 56001-7718
(507) 345-4679
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1352
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
625K8LE
BLUE CROSS BLUE SHIELD
MN
05
—
628128100
—
MN
01
—
HP60847
HEALTH PARTNERS
MN
Enumeration date
11/17/2006
Last updated
04/11/2024
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