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Mara Waller
NPI 1396128427 · on the registry since 2015 · sole proprietor
Practice
- Address
- 500 Robert St N Unit 606
Saint Paul, MN 55101 - Phone
- (612) 581-0468
Registry record
- Primary taxonomy
- 225200000X
225200000X
- Licence states on file
- MN
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2015-07-07
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Minnesota