Individual
GREGORY A HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD, LP
Contact information
Practice address
6950 146TH ST W STE 100, APPLE VALLEY, MN 55124-6544
(952) 432-1484
(952) 432-2328
Mailing address
4240 PARK GLEN RD, ST LOUIS PARK, MN 55416-5427
(612) 925-6033
(612) 925-8496
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP3050
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
108462C154
UCARE
MN
01
—
37P59HA
BCBS
MN
01
—
411425197
CIGNA BEHAVIORAL HEALTH
MN
01
—
6130488
MEDICA CHOICE
MN
05
—
659555300
—
MN
01
—
94379
OPTUM
MN
Enumeration date
11/15/2006
Last updated
01/28/2021
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