Individual
OLIVIA MARIE WALLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LMFT
Contact information
Practice address
4255 PHEASANT RIDGE DR NE STE 412, BLAINE, MN 55449-5066
(763) 703-3754
Mailing address
18673 HARROGATE DR, EDEN PRAIRIE, MN 55346-2012
(952) 693-6207
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
08/28/2020
Last updated
08/14/2023
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