Provider Demographics
NPI:1811416670
Name:GINA DILLY
Entity Type:Organization
Organization Name:GINA DILLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:GINA
Authorized Official - Middle Name:ARLINE
Authorized Official - Last Name:DILLY
Authorized Official - Suffix:
Authorized Official - Credentials:LP
Authorized Official - Phone:507-292-1600
Mailing Address - Street 1:300 1ST AVE NW STE 200
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-2830
Mailing Address - Country:US
Mailing Address - Phone:507-292-1600
Mailing Address - Fax:507-292-1600
Practice Address - Street 1:300 1ST AVE NW STE 200
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-2830
Practice Address - Country:US
Practice Address - Phone:507-292-1600
Practice Address - Fax:507-292-1600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty