Provider Demographics
NPI:1295499358
Name:HAGEN, RACHEL M
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:M
Last Name:HAGEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 MCGREGOR ST APT 402
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03102-3777
Mailing Address - Country:US
Mailing Address - Phone:716-244-1156
Mailing Address - Fax:
Practice Address - Street 1:10 REED ST
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01832-5411
Practice Address - Country:US
Practice Address - Phone:978-372-3626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical