Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
LYLE WALTER WAGNER III, PHD, LP
ActiveLYLE WALTER WAGNER III, PHD, LP is a Clinical Psychologist healthcare provider located in COON RAPIDS, Minnesota. NPI 1649683939 is currently active in the NPPES registry. Verify at CMS.
Clinical Psychologist · COON RAPIDS, MN
Registration Details
- NPI Number
- 1649683939
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 4, 2014 (12.156446397774 yrs)
- Last Updated
- Jun 4, 2014
- License
-
5751 (MN)
Practice Information
- Address
-
3907 COON RAPIDS BLVD NWCOON RAPIDS, MN, 554332520Browse MN providers · Browse ZIP 55433
- Phone
- 3206297600
- Fax
- 6519250071
- Primary Specialty
-
Clinical Psychologist
103TC0700X
Other Clinical Psychologist Providers in COON RAPIDS, MN
| Name | Credential | NPI |
|---|---|---|
| KERRI J LAMBERTY | PHD, ABPP-CN | 1558377283 |
| DR. ROBERT CORNELL VAN SICLEN | PHD | 1871674978 |
| MRS. BRENDA JANICE CRESPO | PSYD | 1720117997 |
| ABBY O'KEEFE STANISLAW | PSYD | 1013242536 |
| WILL GOLD | PSYD, LP | 1891122990 |
| DR. JULIE BRISCO | LP | 1205284445 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.