Individual
HOLLY H HAGSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
405 LAKE SHORE DR E, ASHLAND, WI 54806-1837
(715) 682-3523
(715) 682-3526
Mailing address
61051 E SUMMIT RD, ASHLAND, WI 54806-4402
(715) 682-6266
(715) 682-3526
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3556-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41001100
—
WI
Enumeration date
08/05/2007
Last updated
08/05/2007
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