Individual
JACQUE DEANNE HANSLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
427 N 6TH ST, LAFAYETTE, IN 47901-1189
(765) 420-0938
Mailing address
1205 ADAMS ST, LAFAYETTE, IN 47905-1418
(765) 429-8714
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39001759A
IN
Other
Enumeration date
07/08/2006
Last updated
07/08/2007
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