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Individual

MS. LINDA KATHRYN WALLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LICSW, BCD, DCSW

Contact information

Practice address
300 13TH AVE W STE 1, DICKINSON, ND 58601-4875
(701) 227-7508
(701) 227-7575
Mailing address
300 13TH AVE W STE 1, DICKINSON, ND 58601-4875
(701) 227-7508
(701) 227-7575

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1593
ND
1041C0700X
Clinical Social Worker
Primary
1826
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12661
BC/BS PIN
ND
05
54523
ND
Enumeration date
07/07/2006
Last updated
01/19/2016
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