Organization
VIRAGO WELLNESS INITIATIVE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CASEY HANSON (PSYCHOLOGIST/OWNER)
(920) 428-0580
Entity
Organization
Contact information
Practice address
W6240 COMMUNICATION CT STE 2, APPLETON, WI 54914-8549
(920) 428-0580
Mailing address
W6240 COMMUNICATION CT STE 2, APPLETON, WI 54914-8549
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
09/19/2023
Last updated
11/15/2023
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