Organization
MIDTOWN MANAGEMENT LTD
Active
Other names
Northland Therapy Center
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES WAGNER LMFT (THERAPIST/PARTNER)
(651) 641-1009
Entity
Organization
Contact information
Practice address
2324 UNIVERSITY AVE W, STE 100, ST PAUL, MN 55114-1854
(651) 641-1009
(651) 789-5677
Mailing address
2324 UNIVERSITY AVE W, STE 100, ST PAUL, MN 55114-1854
(651) 641-1009
(651) 789-5677
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
LP 2149
MN
103T00000X
Psychologist
Primary
LP 3528
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
876248100
—
MN
Enumeration date
04/07/2007
Last updated
03/24/2023
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