Individual
JOSEPH R HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
515 S 700 E STE 2A, SALT LAKE CITY, UT 84102-2855
(801) 935-4171
(801) 935-4946
Mailing address
2420 FARETTO LN, RENO, NV 89511-7600
(775) 846-1212
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-18-54355
UT
Other
Enumeration date
04/29/2018
Last updated
04/29/2018
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