Individual
KIM MATHSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
135 FERN ST N, CAMBRIDGE, MN 55008-1033
(763) 689-5385
Mailing address
37233 HELIUM ST NW, DALBO, MN 55017-8639
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7866
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
688G0MA
BCBS
MN
01
—
HP51862
HEALTH PARTNERS
MN
Enumeration date
09/28/2006
Last updated
07/09/2007
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