Individual
MS. JANNA LYNN HACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
302 S. MAIN ST., EDGERTON, WI 53534
(608) 239-7648
Mailing address
302 S. MAIN ST., EDGERTON, WI 53534
(608) 239-7648
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7174-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40933900
—
WI
Enumeration date
03/21/2007
Last updated
04/28/2011
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