Individual
DR. LYLE WALTER WAGNER JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
236 N SIBLEY AVE, LITCHFIELD, MN 55355
(320) 693-7708
(320) 434-2176
Mailing address
236 N SIBLEY AVE, LITCHFIELD, MN 55355-2141
(320) 693-7708
(320) 434-2176
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP0681
MN
Other
Enumeration date
11/14/2006
Last updated
07/06/2018
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