Healthcare Provider Details

I. General information

NPI: 1457862344
Provider Name (Legal Business Name): MARI BEA HOAGLUND LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARI BEA HERNANDEZ LPC

II. Dates (important events)

Enumeration Date: 10/18/2017
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5801 WASHINGTON AVE STE 99A
MT PLEASANT WI
53406-4057
US

IV. Provider business mailing address

5801 WASHINGTON AVE STE 99A
MT PLEASANT WI
53406-4057
US

V. Phone/Fax

Practice location:
  • Phone: 262-939-8959
  • Fax:
Mailing address:
  • Phone: 262-939-8959
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6650-125
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: