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General NPI Number Information
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NPI Number | 1710139837
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Entity Type | Individual
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Provider Name | GISELLE MARY MATSUI M.A.
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Gender | Female
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Dates
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Enumeration Date | 10/21/2008
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Last Update Date | 10/21/2008
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Provider Practice Location Address
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Address Line | 18315 CASCADE DR SUITE 100
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City | EDEN PRAIRIE
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State | MN
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Zip | 55347-1180
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Country | US
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Telephone | 952-294-4327
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Fax | 952-294-1027
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Provider Business Mailing Address
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Address Line | 18315 CASCADE DR SUITE 100
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City | EDEN PRAIRIE
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State | MN
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Zip | 55347-1180
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Country | US
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Telephone | 952-294-4327
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Fax | 952-294-1027
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 7824
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | 7824
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License Number State | MN
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