Individual
JULIA HAGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1532 JEFFERSON STREET, NAPA, CA 94559
(507) 402-7090
Mailing address
17124 760TH AVE, ALBERT LEA, MN 56007-5609
(507) 402-7090
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
1974
CA
Other
Enumeration date
08/24/2010
Last updated
08/24/2010
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