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Individual

MR. IAN JEFFREY AGAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSW, LCSW, CADC III

Contact information

Practice address
WAUSAU VETERANS OUTPATIENT CLINIC, 515 S. 32ND AVENUE, WAUSAU, WI 54401
(715) 842-2834
(715) 845-8211
Mailing address
W15354 COUNTY HIGHWAY D, WITTTENBERG, WI 54499
(715) 793-4411

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
13523
WI
1041C0700X
Clinical Social Worker
Primary
7098-123
WI

Other

Enumeration date
09/13/2006
Last updated
05/08/2014
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