Individual
MRS. ANGELA MARIE HANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
2961 SAINT ANTHONY DR, GREEN BAY, WI 54311-5860
(920) 857-9151
Mailing address
1901 RIDGEWAY DR, DE PERE, WI 54115-3600
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3799-154
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3799-154
SPEECH-LANGUAGE PATHOLOGY LICENSE
WI
Enumeration date
06/12/2013
Last updated
06/19/2013
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