Individual
MR. TED M PAGOAGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
W18105 HEMLOCK RD, WITTENBERG, WI 54499-8647
(715) 253-2116
(715) 253-3586
Mailing address
103 E MCKINLEY ST, STOUGHTON, WI 53589-1624
(605) 873-3103
(608) 873-1999
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6524
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4092550
—
WI
Enumeration date
12/13/2006
Last updated
07/08/2007
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