Organization
ELIZABETH WAGNER, PSYD, LP, INC.
Active
Organization
ELIZABETH WAGNER, PSYD, LP, INC.
Active
Other names
ELEOS Psychology Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELIZABETH WAGNER PSYD (CHIEF EXECUTIVE OFFICER)
(952) 444-9744
Entity
Organization
Contact information
Practice address
4500 PARK GLEN RD, SUITE 450, SAINT LOUIS PARK, MN 55416-4871
(952) 444-9744
(952) 444-9745
Mailing address
4500 PARK GLEN RD, SUITE 450, SAINT LOUIS PARK, MN 55416-4871
(952) 444-9744
(952) 444-9745
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
5833
MN
Other
Enumeration date
05/19/2016
Last updated
07/01/2016
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