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Organization
ABUNDANT ROOTS THERAPY LLC
Active
Organization
ABUNDANT ROOTS THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY C HANSEN LCSW (THERAPIST)
(720) 428-1988
Entity
Organization
Contact information
Practice address
2224 TWENTY GRAND AVE, OWENSBORO, KY 42301-4935
(720) 428-1988
Mailing address
2224 TWENTY GRAND AVE, OWENSBORO, KY 42301-4935
(720) 428-1988
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
NULL
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
04/02/2024
Last updated
04/02/2024
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