Individual
MIRANDA HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LADC
Contact information
Practice address
2217 NICOLLET AVE, MINNEAPOLIS, MN 55404-3382
(612) 216-1709
Mailing address
2217 NICOLLET AVE, MINNEAPOLIS, MN 55404-3382
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
305418
MN
Other
Enumeration date
10/15/2020
Last updated
10/15/2020
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