Individual provider · Type 1 NPI

Petra M. Hagen, SAC

Addiction (Substance Use Disorder) Counselor · Sparta, WI

NPI number 1336979228 Active

Practice location

314 N Black River St
Sparta, WI 54656-1546

Mailing address

314 N Black River
Sparta, WI 54656

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X17129-131 (WI)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1336979228

Petra M. Hagen, SAC's National Provider Identifier is 1336979228, issued on Aug 5, 2024. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Sparta, WI. The record was last updated on Aug 5, 2024.