Individual
MISS AMANDA GEORGEANN HAGMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11449 S 49TH WEST AVE, SAPULPA, OK 74066-8947
(918) 706-1847
Mailing address
11449 S 49TH WEST AVE, SAPULPA, OK 74066-8947
(918) 706-1847
Taxonomy
Speciality
Code
Description
License number
State
103TR0400X
Rehabilitation Psychologist
Primary
—
—
Other
Enumeration date
08/09/2010
Last updated
08/09/2010
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