| Mr Randall Dean Wallace, MS | |
|
133 2nd Ave Sw, Cambridge, MN 55008-1552 | |
| (763) 689-9407 | |
| (763) 552-0164 |
| Full Name | Mr Randall Dean Wallace |
|---|---|
| Gender | Male |
| Speciality | Psychologist |
| Location | 133 2nd Ave Sw, Cambridge, Minnesota |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689768707 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | LP0683 (Minnesota) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Randall Dean Wallace, MS 199 Coon Rapids Blvd Nw, Suite 306, Coon Rapids, MN 55433-5831 Ph: (763) 780-1520 | Mr Randall Dean Wallace, MS 133 2nd Ave Sw, Cambridge, MN 55008-1552 Ph: (763) 689-9407 |
Ms. Suzanne Gayle Wenstrom Pocrnich, M.S., L.P. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 133 2nd Ave Sw, Cambridge, MN 55008 Phone: 763-689-9407 | |
Barbara Olivia Erickson, M.A.L.P. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 237 2nd Ave Sw, Cambridge, MN 55008 Phone: 651-245-5217 | |
Dr. Michael Peter Keller, LP Psychologist Medicare: May Accept Medicare Assignments Practice Location: 701 Dellwood St S, Cambridge, MN 55008 Phone: 763-689-8700 | |
Dr. Richard Anthony Blackburn, PH.D. Psychologist Medicare: Accepting Medicare Assignments Practice Location: 817 Main St N, Cambridge, MN 55008 Phone: 763-325-0300 | |
Dr. Jodi Janice Barstow Boos-blaszyk, PSYD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 701 Dellwood St S, Cambridge, MN 55008 Phone: 612-262-1166 | |
Alaina F Everitt, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 701 Dellwood St S, Cambridge, MN 55008 Phone: 763-689-8700 | |
Marcella Louise Stoeckel, M.A. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 133 2nd Ave Sw, Cambridge, MN 55008 Phone: 763-689-9407 Fax: 763-552-0164 |