Doctor Name: | DR. JANET W HAGEN |
NPI Number: | 1023394913 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | |
Business Practice Address: | 1310 Candlelight Ct Oshkosh, WI - 549047301 |
Business Phone Number: | 9204203825 |
Business Fax Number: | |
Mailing Address: | 1310 Candlelight Ct, OSHKOSH |
State: | WI |
Postal Code: | 549047301 |
Phone Number: | 9204203825 |
Fax Number: | |
NPI Enumeration Date: | 10/24/2011 |
NPI Last Update Date: | 10/24/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |