Individual
COLIN KELLY FAULKNER II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
796 CAPITOL HTS, SAINT PAUL, MN 55103-1852
(651) 558-9522
Mailing address
1246 UNIVERSITY AVE W, SAINT PAUL, MN 55104-4125
(651) 558-9522
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
06/23/2014
Last updated
06/23/2014
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