Individual
KATHERINE WALLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1400 12TH AVE NW, AUSTIN, MN 55912-1912
(507) 437-9152
Mailing address
329 FARIBAULT RD, FARIBAULT, MN 55021-5780
(507) 334-1983
(507) 333-2307
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
16076
MN
1041C0700X
Clinical Social Worker
16076
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16076
LICENSE NUMBER
MN
Enumeration date
09/21/2006
Last updated
04/30/2018
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