Individual
REBECCA HAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC, SLP
Contact information
Practice address
15247 DUPONT PATH, APPLE VALLEY, MN 55124
(612) 423-4852
Mailing address
15247 DUPONT PATH, APPLE VALLEY, MN 55124
(612) 423-4852
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12097902
MN
Other
Enumeration date
04/04/2007
Last updated
07/17/2019
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