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Individual

DR. DONALD C. MATTSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD, ATR, LPC

Contact information

Practice address
3215 TOWER AVE, STE. 108, SUPERIOR, WI 54880-5388
(715) 718-5606
Mailing address
3215 TOWER AVE., STE. 108, SUPERIOR, WI 54880-5269
(715) 718-5606

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
6401012474
MI
101YM0800X
Mental Health Counselor
Primary
5340-125
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1780697078
MI
Enumeration date
06/13/2011
Last updated
09/25/2015
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