Individual
MR. KEVIN HANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
951 NIAGARA STREET, ADOLESCENT PROGRAM, BUFFALO, NY 14213
(716) 818-7195
(716) 884-1758
Mailing address
254 FRANKLIN STREET, LAKE SHORE BEHAVIORAL HEALTH, INC, BUFFALO, NY 14202
(716) 842-0440
(716) 842-4069
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/08/2008
Last updated
04/08/2008
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