Most Relevant Information
Provider Data
| NPI Number: | 1003693441 |
| Provider Name: | BRIAN HAGENBUCH |
| Entity Type: | Individual |
| Taxonomy Code: | 104100000X |
| Specialty: | Social Worker |
| License Number: | S.2309879 |
Most Important Dates
| Enumeration Date: | 09/11/2023 |
| Last Updated: | 09/11/2023 |
Provider Practice Location
474 N YELLOW SPRINGS ST
SPRINGFIELD
OH
455042463
Practice Location Phone/Fax
| Phone: | 9373999500 |
| Fax: |
Provider Mailing Location
474 N YELLOW SPRINGS ST
SPRINGFIELD
OH
455042463
Provider Mailing Phone/Fax
| Phone: | 9373999500 |
| Fax: |