| Doctor Name: | JENNIFER L STAGG |
| NPI Number: | 1609906015 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSW |
| License Number: | |
| Business Practice Address: | 6040 W Lisbon Ave Suite 103 Milwaukee, WI - 532102116 |
| Business Phone Number: | 4144421751 |
| Business Fax Number: | 4144421775 |
| Mailing Address: | 140 N Hine Ave, WAUKESHA |
| State: | WI |
| Postal Code: | 531884316 |
| Phone Number: | 2629935119 |
| Fax Number: | |
| NPI Enumeration Date: | 03/06/2007 |
| NPI Last Update Date: | 11/10/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |