Provider Demographics
NPI:1770689705
Name:GALE VALTINSON & ASSOCIATES PA
Entity Type:Organization
Organization Name:GALE VALTINSON & ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GALE
Authorized Official - Middle Name:R
Authorized Official - Last Name:VALTINSON
Authorized Official - Suffix:
Authorized Official - Credentials:LP
Authorized Official - Phone:612-205-5967
Mailing Address - Street 1:423 WARWICK ST
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55105-2548
Mailing Address - Country:US
Mailing Address - Phone:612-205-5967
Mailing Address - Fax:651-699-5696
Practice Address - Street 1:423 WARWICK ST
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55105-2548
Practice Address - Country:US
Practice Address - Phone:612-205-5967
Practice Address - Fax:651-699-5696
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP 4370103G00000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN680001950Medicare ID - Type UnspecifiedPRIVATE PRACTICE PROVIDER