Individual
MATTHEW MERRITT SHORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW, LICSW
Contact information
Practice address
3001 HENNEPIN AVE, #2170, MINNEAPOLIS, MN 55408-2647
(612) 825-3440
(612) 827-2477
Mailing address
3001 HENNEPIN AVE, #2170, MINNEAPOLIS, MN 55408-2647
(612) 825-3440
(612) 827-2477
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
21474-LICSW
MN
Other
Enumeration date
10/09/2012
Last updated
10/09/2012
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