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NPI 1588734669

NPI 1588734669 : LINDA MARIE WALINSKI LP LICENSED PSYCHOLO : MORA, MN

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General NPI Number Information
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    NPI Number           |    1588734669
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    Entity Type          |    Individual 
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    Provider Name        |    LINDA MARIE WALINSKI LP LICENSED PSYCHOLO
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/08/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    905 FOREST AVE E STE 150
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    City                 |    MORA
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    State                |    MN
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    Zip                  |    55051
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    Country              |    US
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    Telephone            |    320-679-6350
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    Fax                  |    320-679-6351
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Provider Business Mailing Address
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    Address Line         |    911 267TH AVE NW 
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    City                 |    ISANTI
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    State                |    MN
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    Zip                  |    55040
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    Country              |    US
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    Telephone            |    763-444-5087
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    Fax                  |    320-679-6351
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    103TC1900X
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    Taxonomy Name        |    Counseling Psychologist
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    License Number       |    LP3360
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    License Number State |    MN
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