Individual
JAMIE HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
3401 45TH ST S STE A, FARGO, ND 58104-8970
(701) 356-4384
Mailing address
3401 45TH ST S STE A, FARGO, ND 58104-8970
(701) 356-4384
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
08/26/2019
Last updated
08/26/2019
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