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Individual

MR. GARY W HANSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MS, CCC-SLP

Contact information

Practice address
1646 5TH AVE N, ESTHERVILLE, IA 51334-1760
(712) 362-3522
Mailing address
605 22ND AVE N, ESTHERVILLE, IA 51334-1007
(712) 362-3157

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
00858
IA

Other

Enumeration date
03/23/2007
Last updated
07/08/2007
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