Individual
CONSTANCE A HAGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
515 BAYOU ST, VINCENNES, IN 47591-1034
(812) 886-6800
(812) 886-6809
Mailing address
515 BAYOU ST, VINCENNES, IN 47591-1034
(812) 886-6800
(812) 886-6809
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34003590A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000201548
ANTHEM BLUE CROSS
IN
Enumeration date
12/28/2005
Last updated
05/04/2010
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