Individual
SUSAN JANE HAGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
410 WINDWARD WAY, KALISPELL, MT 59901-2680
(406) 257-1336
(406) 257-1353
Mailing address
410 WINDWARD WAY, KALISPELL, MT 59901-2680
(406) 257-1336
(406) 257-1353
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1104
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000255527
—
MT
Enumeration date
12/21/2006
Last updated
12/15/2009
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