Healthcare Provider Details

I. General information

NPI: 1497126924
Provider Name (Legal Business Name): SARAH HAGER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2015
Last Update Date: 10/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

655 WEST 8TH STREET C-307
JACKSONVILLE FL
32209
US

IV. Provider business mailing address

655 WEST 8TH STREET C-307
JACKSONVILLE FL
32209
US

V. Phone/Fax

Practice location:
  • Phone: 904-244-3397
  • Fax: 904-244-2896
Mailing address:
  • Phone: 904-244-3397
  • Fax: 904-244-2896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: