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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