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Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANGELA HANSEN LCSW (OWNER)
(208) 887-1911
Entity
Organization

Contact information

Practice address
403 W CHERRY LN, MERIDIAN, ID 83642-1610
(208) 887-1911
(208) 895-8049
Mailing address
403 W CHERRY LN, MERIDIAN, ID 83642-1610
(208) 887-1911
(208) 895-8049

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-34104
ID

Other

Enumeration date
05/05/2016
Last updated
05/05/2016
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