Individual
NICOLE M HAGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
2679 WIHEGA RD, ARBOR VITAE, WI 54568-8802
(715) 356-5989
Mailing address
2679 WIHEGA RD, ARBOR VITAE, WI 54568-8802
(715) 356-5989
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2572-154
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42561400
—
WI
Enumeration date
10/17/2006
Last updated
03/13/2014
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