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1043260110
GARY A WALLINGA
SAINT CLOUD, MN
NPI
1043260110
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
103TC2200X Psychologist, Clinical Child & Adolescent
(Licence: MN LP2053)
Enumeration Date
2006-05-11
Last Update Date
2007-07-08
Business Address
-- GARY A WALLINGA PhD LP
1900 CENTRACARE CIR SUITE 1325
SAINT CLOUD, MN 56303-5000
Phone number: 320-255-5796
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Mailing Address
-- GARY A WALLINGA PhD LP
1406 6TH AVE N
SAINT CLOUD, MN 56303-1900
Phone number: 320-251-2700
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