Individual
MS. SHELLY HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1414 W LOMBARD ST, DAVENPORT, IA 52804-2148
(563) 326-6431
Mailing address
1414 W LOMBARD ST, DAVENPORT, IA 52804-2148
(563) 326-6431
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
107970
IA
1041C0700X
Clinical Social Worker
149.025995
IL
Other
Enumeration date
08/11/2019
Last updated
12/29/2023
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