Provider Demographics
NPI:1710139837
Name:MATSUI, GISELLE MARY (MA)
Entity Type:Individual
Prefix:
First Name:GISELLE
Middle Name:MARY
Last Name:MATSUI
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18315 CASCADE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55347-1180
Mailing Address - Country:US
Mailing Address - Phone:952-294-4327
Mailing Address - Fax:952-294-1027
Practice Address - Street 1:18315 CASCADE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55347-1180
Practice Address - Country:US
Practice Address - Phone:952-294-4327
Practice Address - Fax:952-294-1027
Is Sole Proprietor?:No
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7824231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter