Individual provider · Type 1 NPI

Matthew Thiede

Mental Health Counselor · Maple Grove, MN

NPI number 1164015384 Active

Practice location

12918 63rd Ave N
Maple Grove, MN 55369-6001

Call (763) 210-9966 Map

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1164015384

Matthew Thiede's National Provider Identifier is 1164015384, issued on Feb 18, 2021. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Maple Grove, MN. The record was last updated on Feb 18, 2021.