Individual
MR. GREGORY DAVID WALSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
1600 ARBORETUM BLVD, SUITE # 211, VICTORIA, MN 55386-7705
(952) 443-3970
(952) 368-3177
Mailing address
PO BOX 82, VICTORIA MENTAL HEALTH SERVICES, LTD., VICTORIA, MN 55386-0082
(952) 443-3970
(952) 368-3177
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
—
—
1041C0700X
Clinical Social Worker
Primary
9379
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0488739-00
—
MN
05
—
048873900
—
MN
01
—
6236362
MEDICA-UBH
—
Enumeration date
07/05/2006
Last updated
08/11/2010
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