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Individual

KATIE HAGEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
1717 TAYLOR AVENUE, RACINE, WI 53403
(262) 224-5224
Mailing address
9256 W ALLERTON AVE, GREENFIELD, WI 53228-2706
(262) 224-5224

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7758-123
WI
1041C0700X
Clinical Social Worker
SW12025
FL

Other

Enumeration date
06/03/2011
Last updated
05/18/2015
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