Individual
MRS. JENNIFER LYNN HAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
1860 AUBURN LN APT 19C, SURFSIDE BEACH, SC 29575-5157
(843) 685-8633
Mailing address
1860 AUBURN LN APT 19C, SURFSIDE BEACH, SC 29575-5157
(843) 685-8633
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
09/17/2014
Last updated
09/17/2014
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