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Individual

JASON L WALKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD LP

Contact information

Practice address
347 NORTH SMITH AVENUE, CHILDRENS SPECIALTY CLINIC PSYCHOLOGICAL SERVICES STPL, ST PAUL, MN 55102
(651) 220-6720
(651) 220-6707
Mailing address
2910 CENTRE POINTE DRIVE, 35-121A, ROSEVILLE, MN 55113
(651) 855-2327
(651) 855-2310

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP3077
MN
103TC0700X
Clinical Psychologist
LP3077
MN
103TC2200X
Clinical Child & Adolescent Psychologist
LP3077
MN
103TH0100X
Health Service Psychologist
LP3077
MN

Other

Enumeration date
08/16/2006
Last updated
09/11/2025
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