Individual
JESSICA HAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC, NCC
Contact information
Practice address
2563 S VAL VISTA DR, SUITE 108, GILBERT, AZ 85295-1804
(480) 448-1076
(480) 646-8811
Mailing address
2563 S VAL VISTA DR, SUITE 108, GILBERT, AZ 85295-1804
(480) 448-1076
(480) 646-8811
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LAC-13921
AZ
101YM0800X
Mental Health Counselor
Primary
LPC-15686
AZ
Other
Enumeration date
03/30/2015
Last updated
01/12/2016
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