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General NPI Number Information
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NPI Number | 1225746506
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Entity Type | Individual
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Provider Name | ANNIE HAGEN
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Gender | Female
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Dates
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Enumeration Date | 11/07/2022
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Last Update Date | 11/07/2022
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Provider Practice Location Address
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Address Line | 10300 SUNSET DR STE 140
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City | MIAMI
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State | FL
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Zip | 33173-3038
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Country | US
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Telephone | 305-302-4776
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Fax |
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Provider Business Mailing Address
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Address Line | 103400 OVERSEAS HWY STE 250
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City | KEY LARGO
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State | FL
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Zip | 33037-2831
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Country | US
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Telephone | 305-302-4776
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | SS1726
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License Number State | FL
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