Individual
MR. TIMOTHY PHILLIP FAUST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
126 W BAYFIELD ST, WASHBURN, WI 54891-1182
(715) 373-0480
(715) 373-0480
Mailing address
PO BOX 3, 126 W BAYFIELD STREET, WASHBURN, WI 54891-0003
(715) 373-0480
(715) 373-0480
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW4352123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4220850
—
WI
Enumeration date
06/21/2007
Last updated
09/15/2013
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