Individual
MARY G MATTISON-WYNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY D LP
Contact information
Practice address
30 1ST AVE NE # 12, BUFFALO, MN 55313-1515
(612) 670-8918
(952) 300-8194
Mailing address
PO BOX 80, HAMEL, MN 55340-0080
(612) 670-8918
(952) 300-8194
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP4961
MN
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
4961
MN
Other
Enumeration date
07/07/2006
Last updated
09/30/2024
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