Individual
MS. KATHLEEN ANNETTE HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
4801 VETERANS DR, SAINT CLOUD, MN 56303-2015
(320) 252-1670
Mailing address
4801 VETERANS DR, SAINT CLOUD, MN 56303-2015
(320) 252-1670
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
575
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
575
ND BOARD OF SOCIAL WORK
ND
Enumeration date
12/17/2007
Last updated
12/17/2007
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