Wallace, Randall Dean
Wallace, Randall Dean is an individual health care provider with primary practice located at 133 2Nd Ave Sw , Cambridge MN 55008-1552. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Wallace, Randall Dean can be contacted via phone (763) 689-9407.Contact Information
Primary practice address
133 2Nd Ave Sw
Cambridge MN 55008-1552
Phone: (763) 689-9407
Fax: (763) 552-0164
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | LP0683 | Minnesota |
Profile Details
| NPI number | 1689768707 |
|---|---|
| LBN Legal business name | Wallace, Randall Dean |
| Credentials | M.S. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 3rd, 2006 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Popular Providers
-
Boothe, Jason
4310 James Casey St Bldg 2, Austin TX 78745-1120 -
Salais, A. Joseph
3000 Citrus Cir Ste 200, Walnut Creek CA 94598-2665 -
Lininger, Robert Stewart
133 2Nd Ave Sw , Cambridge MN 55008-1552 -
Keilin, William Gregory
3355 Bee Caves Rd Ste 104, Austin TX 78746-6673 -
Dove, William R
224 E Willamette Ave , Colorado Springs CO 80903-1114 -
Keller, Michael Peter
701 Dellwood St S , Cambridge MN 55008-1920 -
Sigler, Todd Michael
1935 County Road B2 W Ste 270 , Roseville MN 55113-2785 -
Jensen, Gerald Edward
2155 Antler Dr Sw , Brainerd MN 56401-2589