Individual
ELIZABETH WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
3800 PARK NICOLLET BLVD, ST LOUIS PARK, MN 55416-2527
(952) 993-2498
Mailing address
3800 PARK NICOLLET BLVD, ST LOUIS PARK, MN 55416-2527
(952) 993-2498
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
2757
MN
Other
Enumeration date
07/13/2015
Last updated
02/07/2020
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