Individual
KAITLYN MATTESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LADC
Contact information
Practice address
1614 MAHTOMEDI AVE, MAHTOMEDI, MN 55115-1909
(612) 662-3989
(612) 500-4852
Mailing address
3100 GLEN OAKS AVE, WHITE BEAR LAKE, MN 55110-5698
(651) 675-8151
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/24/2024
Last updated
10/03/2025
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