Individual
MR. ROGER DALE PAGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSE, LCSW
Contact information
Practice address
320 W GRAND AVE STE 304A, WISCONSIN RAPIDS, WI 54495-2781
(715) 424-6960
(715) 424-6963
Mailing address
320 W GRAND AVE STE 304A, WISCONSIN RAPIDS, WI 54495-2781
(715) 424-6960
(715) 424-6963
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2117-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39599600
—
WI
Enumeration date
11/28/2006
Last updated
07/09/2007
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