Individual
DR. EMMANUELLE HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
3450 OLEARY LN, EAGAN, MN 55123-2340
(651) 454-0114
Mailing address
3625 33RD AVE S, MINNEAPOLIS, MN 55406-2726
(763) 607-3108
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
LP6680
MN
103T00000X
Psychologist
Primary
—
—
103TB0200X
Cognitive & Behavioral Psychologist
LP6680
MN
103TC0700X
Clinical Psychologist
Primary
LP6680
MN
103TC2200X
Clinical Child & Adolescent Psychologist
LP6680
MN
103TF0000X
Family Psychologist
LP6680
MN
Other
Enumeration date
03/22/2021
Last updated
03/22/2026
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