Provider Demographics
NPI:1104973411
Name:HAGAN, MARGARET L (PHD)
Entity type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:L
Last Name:HAGAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 VILLAGE STREET
Mailing Address - Street 2:SUITE A
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458
Mailing Address - Country:US
Mailing Address - Phone:985-718-5858
Mailing Address - Fax:
Practice Address - Street 1:119 VILLAGE STREET
Practice Address - Street 2:SUITE A
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458
Practice Address - Country:US
Practice Address - Phone:985-718-5858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA441103T00000X
LA103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA179689OtherVALUE OPTIONS
LA4H376Medicare ID - Type Unspecified