Individual
MELANIE WALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
4600 77TH ST W STE 370, EDINA, MN 55435-4912
(612) 464-1400
(612) 315-6001
Mailing address
4600 77TH ST W STE 370, EDINA, MN 55435-4912
(612) 464-1400
(612) 315-6001
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
24772
MN
Other
Enumeration date
12/21/2020
Last updated
04/20/2026
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