Individual
ANNA MARIE HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5186 SCORESBY AVE, IONA, ID 83427-5015
(208) 520-8392
Mailing address
5186 SCORESBY AVE, IONA, ID 83427-5015
(208) 520-8392
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A0009941
—
ID
Enumeration date
08/31/2022
Last updated
08/31/2022
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