Individual
WALLIS MARLEN LUIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MFTC
Contact information
Practice address
12101 E 2ND AVE STE 100, AURORA, CO 80011-8328
(720) 810-4063
(303) 364-3932
Mailing address
1427 ROYAL TROON DR, CASTLE ROCK, CO 80104-5245
(786) 417-5379
(786) 600-3993
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ACD.0000981
CO
Other
Enumeration date
06/16/2015
Last updated
10/09/2019
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