Individual
DR. AMY WAGENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D/LP
Contact information
Practice address
1755 SOUTHCROSS DR W, BURNSVILLE, MN 55306-7012
(952) 898-5020
(952) 898-5858
Mailing address
1755 SOUTHCROSS DR W, BURNSVILLE, MN 55306-7012
(952) 898-5020
(952) 898-5858
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP4350
MN
Other
Enumeration date
08/04/2011
Last updated
08/04/2011
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