Individual
LINDSEY HAGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
510 SE 13TH ST, GRAND RAPIDS, MN 55744-4233
(218) 327-2570
(218) 326-1036
Mailing address
1215 SE 7TH AVE, GRAND RAPIDS, MN 55744-4201
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
302768
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053500017
—
MN
05
—
188856100
—
MN
Enumeration date
01/18/2010
Last updated
01/18/2010
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