Individual
DAVID WANGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8 N 2ND AVE E, #206, DULUTH, MN 55802-2102
(218) 727-2445
Mailing address
8 N 2ND AVE E, #206, DULUTH, MN 55802-2102
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP0058
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
74890WA
BCBSMN
MN
Enumeration date
04/09/2007
Last updated
07/08/2007
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