Organization
ALLINA HEALTH SYSTEM
Active
Other names
Allina Health Faribault Medical Center Professional Services
Organization subpart
No
Provider details
NPI number
Authorized official
DOMINICA TALLARICO (COO)
(612) 222-2222
Entity
Organization
Contact information
Practice address
200 STATE AVE, FARIBAULT, MN 55021-6339
(507) 334-6451
Mailing address
PO BOX 43, MAIL ROUTE 10585, MINNEAPOLIS, MN 55440-0043
(612) 262-1166
Taxonomy
Speciality
Code
Description
License number
State
103TP2701X
Group Psychotherapy Psychologist
—
—
207L00000X
Anesthesiology Physician
—
—
207P00000X
Emergency Medicine Physician
Primary
—
—
2084P0800X
Psychiatry Physician
—
—
Other
Enumeration date
04/24/2014
Last updated
02/24/2025
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