Elizabeth Wagner in Saint Louis Park - Clinical
Elizabeth Wagner - NPI 1922128529
Elizabeth Wagner is a Clinical in Saint Louis Park, Minnesota. Elizabeth Wagner practices all healthcare services and medical treatments related to Clinical. The NPI Number for Elizabeth Wagner is 1922128529. The last update date is 2016-07-01.
Elizabeth Wagner's current location address is 4500 Park Glen Rd, Saint Louis Park, Minnesota. You can contact this provider via phone number 9524449744 and fax number 9524449745. The mailing address for Elizabeth Wagner is 4500 Park Glen Rd, Saint Louis Park, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Elizabeth Wagner |
|---|---|
| Address | 4500 Park Glen Rd, Saint Louis Park, Minnesota |
| Phone Number | 9524449744 |
| Fax Number | 9524449745 |
| Sole Proprietor | N |
| Credentials | PSYD |
NPI Number Detail
| NPI Number | 1922128529 |
|---|---|
| Provider Enumeration Date | 2007-03-29 |
| Last Updated Date | 2016-07-01 |
Provider Mailing Address Detail
| Address | 4500 Park Glen Rd |
|---|---|
| City | Saint Louis Park |
| State | Minnesota (MN) |
| Post Code | 554164871 |
| Phone Number | 9524449744 |
| Fax Number | 9524449745 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | LP5833 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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What is the unique identifier code issued to Elizabeth Wagner by the Centers for Medicare & Medicaid Services?
The Elizabeth Wagner has been assigned the NPI (National Provider Identifier) 1922128529. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Elizabeth Wagner's physical address?
The Elizabeth Wagner is physically located at 4500 Park Glen Rd, in the city of Saint Louis Park, MN, with the postal code 554164871.
What is Elizabeth Wagner's specialized field of practice, and what is the corresponding taxonomy classification code?
The Elizabeth Wagner's area of specialization is Clinical, and the corresponding taxonomy code that categorizes this field of practice is 103Tc0700X.
On what date was the 1922128529 assigned to Elizabeth Wagner?
The Elizabeth Wagner was issued its 1922128529 on 2007-03-29, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
When was the information related to Elizabeth Wagner most recently updated or refreshed?
The details pertaining to the Elizabeth Wagner, including its address, specialty, and other relevant information, were last updated or refreshed on 2016-07-01.
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