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Search › Minnesota › 1041C0700X

Jody Wallin, LICSW

NPI 1124449392 · on the registry since 2013

Practice

Address
12915 63rd Ave N
Maple Grove, MN 55369
Phone
(952) 826-8465
Organisation at this address
Andrea Rude
Prairiecare
Paragon Residential Treatment For Youth Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
14

Registry record

Primary taxonomy
1041C0700X
1041C0700X
Licence states on file
MN
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2013-12-13

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Minnesota