Hagen, Jody Lynn

Hagen, Jody Lynn is an individual health care provider with primary practice located at 2115 S Fremont Ave Ste 3000 , Springfield MO 65804-2215. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Neuropsychologist, which is considered as her primary health care specialty. Hagen, Jody Lynn can be contacted via phone (417) 820-7708.

Contact Information

Primary practice address
2115 S Fremont Ave Ste 3000 Springfield MO 65804-2215
Phone: (417) 820-7708
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X 2006010348 Missouri

Profile Details

NPI number 1962405563
LBN Legal business name Hagen, Jody Lynn
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date May 27th, 2005
Last updated Sep 7th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962405563 NPPES
Arkansas Other 5Y075 BLUE CROSS/BLUE SHIELD

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