Individual
DR. ELIZABETH WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
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
LP5833
MN
Other
Enumeration date
03/29/2007
Last updated
07/01/2016
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