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Organization

DANIEL L WISE, PH.D., PA

Active
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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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