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Organization

ALLINA HEALTH SYSTEM

Active
Other names
Telepsychiatry Services
Organization subpart
No

Provider details

NPI number
Authorized official
DOMINICA TALLARICO (COO)
(612) 222-2222
Entity
Organization

Contact information

Practice address
4050 COON RAPIDS BLVD NW, COON RAPIDS, MN 55433-2522
(612) 262-1166
Mailing address
PO BOX 43, MAIL ROUTE 10585, MINNEAPOLIS, MN 55440-0043
(612) 262-1166

Taxonomy

Speciality
Code
Description
License number
State
2084B0040X
Behavioral Neurology & Neuropsychiatry Physician
Primary

Other

Enumeration date
02/22/2018
Last updated
02/25/2025
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