| Doctor Name: | MR. TED M PAGOAGA |
| NPI Number: | 1780745430 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MSW |
| License Number: | 6524 |
| Business Practice Address: | W18105 Hemlock Rd Wittenberg, WI - 544998647 |
| Business Phone Number: | 7152532116 |
| Business Fax Number: | 7152533586 |
| Mailing Address: | 103 E Mckinley St, STOUGHTON |
| State: | WI |
| Postal Code: | 535891624 |
| Phone Number: | 6058733103 |
| Fax Number: | 6088731999 |
| NPI Enumeration Date: | 12/13/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 6524 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |