Individual
MR. MATTHEW JAMES WOLMUTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW, LICSW
Contact information
Practice address
1123 GRAND AVE, SUITE 203, SAINT PAUL, MN 55105-2629
(651) 341-5215
Mailing address
1123 GRAND AVE, SUITE 203, SAINT PAUL, MN 55105-2629
(651) 341-5215
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
18763
MN
Other
Enumeration date
12/06/2011
Last updated
06/12/2012
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