Wagner, Lori Ann

Wagner, Lori Ann is an individual health care provider with primary practice located at 1385 Mendota Heights Rd Ste 200 , Mendota Heights MN 55120-1289. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Wagner, Lori Ann can be contacted via phone (651) 379-9800.

Contact Information

Primary practice address
1385 Mendota Heights Rd Ste 200 Mendota Heights MN 55120-1289
Phone: (651) 379-9800
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X CC01011 Minnesota
Behavioral Health & Social Service Providers / Professional 101YP2500X CC01011 Minnesota

Profile Details

NPI number 1538542246
LBN Legal business name Wagner, Lori Ann
Credentials LPCC
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 30th, 2015
Last updated Mar 17th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538542246 NPPES
Minnesota MEDICAID 1538542246

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