Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 8054-123 | WI |
N | 225C00000X | Rehabilitation Counselor |
NPI | 1033314521 |
---|---|
Provider Name | Emily Hagenmaier |
First Address | Madison, WI 53719-1177 |
Second Address | Madison, WI 53719-1177 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2007 |
Last Update Date | 15/02/2019 |