| Doctor Name: | MR. BRIAN LEROY WALLIN |
| NPI Number: | 1558464495 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | |
| Business Practice Address: | Sioux Falls Va Medical Center, 2501 W. 22nd Street Sioux Falls, SD - 571175046 |
| Business Phone Number: | 6053363230 |
| Business Fax Number: | 6053336804 |
| Mailing Address: | 3234 S Serenity Trl, SIOUX FALLS |
| State: | SD |
| Postal Code: | 571036576 |
| Phone Number: | 6052750864 |
| Fax Number: | |
| NPI Enumeration Date: | 09/06/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |