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
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 17129-131 (WI) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
Other addiction (substance use disorder) counselor providers in Sparta
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.