Doctor Name: | JOHANNA M HAGER |
NPI Number: | 1346257813 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.C.P.C., D.B.C.F.C. |
License Number: | |
Business Practice Address: | 698 Oakwood Pl Geneseo, IL - 612541916 |
Business Phone Number: | 3099455739 |
Business Fax Number: | |
Mailing Address: | Po Box 116, GENESEO |
State: | IL |
Postal Code: | 612540116 |
Phone Number: | 3099455739 |
Fax Number: | |
NPI Enumeration Date: | 08/01/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |