Wallace, Dustin P

Wallace, Dustin P is an individual health care provider with primary practice located at 2401 Gillham Rd , Kansas City MO 64108-4619. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Child & Adolescent, which is considered as his primary health care specialty. Wallace, Dustin P can be contacted via phone (816) 234-3000.

Contact Information

Primary practice address
2401 Gillham Rd Kansas City MO 64108-4619
Phone: (816) 234-3000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X 2010009609 Missouri

Profile Details

NPI number 1710143250
LBN Legal business name Wallace, Dustin P
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 4th, 2008
Last updated Feb 3rd, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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