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Individual

MS. JODY HANSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.A., L.P.C., N.C.C.

Contact information

Practice address
14500 S OUTER 40 RD STE 108, CHESTERFIELD, MO 63017-5736
(314) 488-8798
Mailing address
345 REMINGTON WAY DR, BALLWIN, MO 63021-6379
(636) 230-9258

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2001014183
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
025825
VMC
MO
01
241027937
UNITED HEALTH CARE
MO
01
246952
COMPSYCH
MO
01
574624000
MAGELLAN
MO
Enumeration date
10/27/2005
Last updated
11/11/2009
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