Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Dustin P Wallace, PHD

Individual provider Clinical Child & Adolescent Psychologist · NPI 1710143250

Dr. Dustin P Wallace, PHD is a Clinical Child & Adolescent Psychologist in Kansas City, Missouri. Licensed in Missouri. Registered with an NPI since 2008.

Licensed in
MO
In the registry since
2008
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

2401 Gillham Rd
Kansas City, MO 64108-4619
Phone: (816) 234-3000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Child & Adolescent Psychologist (primary) Taxonomy 103TC2200X · Licence 2010009609 (MO)

Record details

NPI number1710143250
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorNo
NPI enumeratedAugust 4, 2008
Last updated in NPPESFebruary 3, 2015

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