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1518670371
MATTHEW IWATA
SAINT PAUL, MN
NPI
1518670371
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: MN 24616)
Enumeration Date
2022-12-26
Last Update Date
2022-12-26
Business Address
MATTHEW IWATA LICSW
1060 GRAND AVE UNIT 211
SAINT PAUL, MN 55105-3820
Phone number: 612-208-2865
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Mailing Address
MATTHEW IWATA LICSW
2136 FORD PKWY # 5481
SAINT PAUL, MN 55116-2850
Phone number: 612-208-2865
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