Individual
FAITH ANN WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., L.P.C.
Contact information
Practice address
8931 HURON ST, THORNTON, CO 80260-6806
(303) 853-3500
Mailing address
8931 HURON ST, THORNTON, CO 80260-6806
(303) 853-3500
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1980
KS
101YM0800X
Mental Health Counselor
RC00055242
WA
101YP2500X
Professional Counselor
Primary
LPC.0015471
CO
Other
Enumeration date
07/31/2006
Last updated
07/02/2019
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