Individual
FAYE WALLUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
12900 TECHNOLOGY DR APT 654, EDEN PRAIRIE, MN 55344-2930
(651) 503-5968
Mailing address
12900 TECHNOLOGY DR APT 654, EDEN PRAIRIE, MN 55344-2930
(651) 503-5968
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
1162-124
WI
106H00000X
Marriage & Family Therapist
Primary
2579
MN
Other
Enumeration date
02/02/2017
Last updated
09/19/2024
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