Individual
CONNIE HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14 PACELLA PARK DR, RANDOLPH, MA 02368-1756
(781) 437-1358
(781) 437-1220
Mailing address
14 PACELLA PARK DR, RANDOLPH, MA 02368-1756
(781) 437-1358
(781) 437-1220
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110026265
—
MA
Enumeration date
11/28/2012
Last updated
11/28/2012
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