Individual
TARA DAWN HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
10004 GLACIER HWY, JUNEAU, AK 99801-8560
(907) 500-4888
Mailing address
10004 GLACIER HWY, JUNEAU, AK 99801
(907) 500-4888
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
101560
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101560
LINCENSED MASSAGE THERAPY
AK
Enumeration date
05/30/2017
Last updated
07/21/2022
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