Individual
DANIEL LYNN WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD, LP
Contact information
Practice address
5200 WILLSON RD STE 205, EDINA, MN 55424-1343
(612) 875-4449
Mailing address
5200 WILLSON RD STE 205, EDINA, MN 55424-1343
(612) 875-4449
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
2014023517
MO
103TC0700X
Clinical Psychologist
LP 1925
KS
103TC0700X
Clinical Psychologist
Primary
LP6424
MN
Other
Enumeration date
05/16/2009
Last updated
10/08/2025
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