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Lyle Walter Wagner III, PHD,LP
Clinical Psychologist in Coon Rapids, Minnesota
NPI 1649683939

Lyle Walter Wagner III is a Clinical Psychologist based in Pine City, MN and is specialized in Clinical. Lyle Walter Wagner III practices in Coon Rapids, MN and has the professional credentials of PHD,LP. The NPI Number for Lyle Walter Wagner III is 1649683939 and holds a License No. 5751 (Minnesota).

The current practice location address for Lyle Walter Wagner III is 3907 Coon Rapids Blvd Nw, Coon Rapids, MN and can be reached out via phone at 320-629-7600 and via fax at 651-925-0071. You can also correspond with Lyle Walter Wagner III through the mailing address at 220 RAILROAD ST SE, PINE CITY, MN - 55063-1540 (mailing address contact number: 320-629-7600).

Location: 3907 Coon Rapids Blvd Nw, Coon Rapids, MN, 55063-1540
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1649683939
Provider Name
Lyle Walter Wagner III
Credential
PHD,LP
Provider Entity Type
Individual
Gender
Male
Address
3907 Coon Rapids Blvd Nw, Coon Rapids, MN, 55063-1540
Phone Number
320-629-7600
Fax Number
651-925-0071
Provider Enumeration Date
06/04/2014
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
3907 Coon Rapids Blvd Nw
City
Coon Rapids
State
Minnesota
Zip
55433-2520
Phone Number
320-629-7600
Fax Number
651-925-0071
person
Provider Business Mailing Address Details
Address
3907 Coon Rapids Blvd Nw
City
Coon Rapids
State
Minnesota
Zip
55433-2520
Phone Number
320-629-7600
Fax Number
651-925-0071
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Psychologist
Speciality
Clinical
Taxonomy
103TC0700X
License No.
5751 (Minnesota)
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 breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
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