Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | SA60775583 | WA |
NPI | 1003381492 |
---|---|
Provider Name | Amy J Hagins |
First Address | Spokane, WA 99201-0206 |
Second Address | Spokane, WA 99201-0206 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2018 |
Last Update Date | 11/10/2018 |