Individual
EMILY SUZANNE WAYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
2526 ULYSSES ST NE, MINNEAPOLIS, MN 55418-3949
(612) 584-1983
Mailing address
2526 ULYSSES ST NE, MINNEAPOLIS, MN 55418-3949
(612) 584-1983
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
CC02947
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CC02947
LPCC
MN
Enumeration date
03/29/2022
Last updated
03/29/2022
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