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1508073271
KIMEKO JEAN HAGEN
APPLETON, WI
NPI
1508073271
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI 14280-130)
Enumeration Date
2007-05-16
Last Update Date
2007-07-08
Business Address
Mrs. KIMEKO JEAN HAGEN B.S, SAC-IT
4000 W SPENCER ST
APPLETON, WI 54914-4015
Phone number: 920-735-9010
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Mailing Address
Mrs. KIMEKO JEAN HAGEN B.S, SAC-IT
13 NORTH GREVES COURT
APPLETON, WI 54914
Phone number: 920-993-9661
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