Individual
JENNIFER MARCUM HAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1109 METALWOOD DR, BARDSTOWN, KY 40004-2635
(502) 331-2680
Mailing address
104 WESTVIEW DR, BARDSTOWN, KY 40004-1834
(502) 331-2680
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
200400860
KY
Other
Enumeration date
03/10/2019
Last updated
03/10/2019
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