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Individual

BRUCE R HANSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MS CCC SLP

Contact information

Practice address
1104 7TH AVE SOUTH, MSUM BOX 119, MOORHEAD, MN 56563-0001
(218) 477-4641
(218) 477-4392
Mailing address
1104 7TH AVE SOUTH, MSUM BOX 119, MOORHEAD, MN 56563-0001
(218) 477-5953
(218) 477-4392

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7237
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
18427
BCBS
ND
05
51834
ND
01
61B51HA
BCBS
MN
Enumeration date
09/29/2006
Last updated
07/08/2007
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