Individual
JESSICA J HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1614 SE STEPHENS ST, ROSEBURG, OR 97470-4000
(541) 375-0314
(541) 440-3554
Mailing address
PO BOX 721, ROSEBURG, OR 97470-0151
(541) 375-0314
(541) 896-4120
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C2891
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500646807
—
OR
Enumeration date
07/12/2012
Last updated
08/09/2016
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