Individual
SHANE HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.ED
Contact information
Practice address
263 WIND CHIME DR, SOMERSET, KY 42503-3821
(606) 875-0812
Mailing address
263 WIND CHIME DR, SOMERSET, KY 42503-3821
(606) 875-0812
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
11/08/2018
Last updated
11/08/2018
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