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1710143250
DUSTIN P WALLACE
KANSAS CITY, MO
NPI
1710143250
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
103TC2200X Psychologist, Clinical Child & Adolescent
(Licence: MO 2010009609)
Enumeration Date
2008-08-04
Last Update Date
2015-02-03
Business Address
Dr. DUSTIN P WALLACE PhD
2401 GILLHAM RD
KANSAS CITY, MO 64108-4619
Phone number: 816-234-3000
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Mailing Address
Dr. DUSTIN P WALLACE PhD
2401 GILLHAM RD
KANSAS CITY, MO 64108-4619
Phone number: 816-234-3000
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