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Individual

MR. MATTHEW KEITH SISSONS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MA

Contact information

Practice address
11 2ND ST SW, WADENA, MN 56482-1482
(320) 639-2025
Mailing address
PO BOX 367, LITTLE FALLS, MN 56345-0367
(320) 639-2025
(320) 200-7527

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
IMH17584
FL
101Y00000X
Counselor
MH21911
FL
101YM0800X
Mental Health Counselor
Primary
3929
MN

Other

Enumeration date
01/23/2019
Last updated
12/13/2023
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