Individual
JESSICA TATYANA HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
85 E 2000 N, TOOELE, UT 84074-9280
(435) 225-1068
Mailing address
352 W 440 S, TOOELE, UT 84074-2909
(435) 225-1068
Taxonomy
Speciality
Code
Description
License number
State
226000000X
Recreational Therapist Assistant
Primary
13901975-4003
UT
Other
Enumeration date
04/18/2024
Last updated
04/18/2024
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