Individual
LORI AB WIGGENHORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LP
Contact information
Practice address
3640 TALMAGE CIR STE 205, VADNAIS HEIGHTS, MN 55110-4184
(612) 388-5236
(612) 326-3359
Mailing address
3640 TALMAGE CIR STE 205, VADNAIS HEIGHTS, MN 55110-4184
(612) 388-5236
(612) 326-3359
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP3703
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200731439
—
MN
Enumeration date
09/21/2006
Last updated
02/19/2019
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