Individual
MARY JO FAUSTGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
5821 CEDAR LAKE RD S, ST LOUIS PARK, MN 55416-1487
(651) 647-1900
Mailing address
9200 40 1/2 AVE N, MINNEAPOLIS, MN 55427-1012
(651) 647-1900
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1041
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790880821
—
MN
Enumeration date
09/13/2006
Last updated
08/20/2020
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