Organization
DANIEL L WISE, PH.D., PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL WISE PH.D. (PRESIDENT/LICENSED PSYCHOLOGIST)
(612) 875-4449
Entity
Organization
Contact information
Practice address
5200 WILLSON RD STE 205, EDINA, MN 55424-1343
(612) 875-4449
Mailing address
5200 WILLSON RD STE 205, MINNEAPOLIS, MN 55424-1343
(612) 875-4449
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
06/15/2021
Last updated
08/24/2021
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