Individual
MR. MATTHEW JON THORSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
11900 WAYZATA BLVD STE 100, MINNETONKA, MN 55305-2018
(612) 454-2011
(952) 546-1683
Mailing address
11900 WAYZATA BLVD STE 100, MINNETONKA, MN 55305-2018
(612) 454-2011
(952) 546-1683
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
304783
MN
Other
Enumeration date
12/18/2018
Last updated
12/18/2018
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