Individual
TRACI LYN HAKANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISCW
Contact information
Practice address
301 FULLER ST S, SHAKOPEE, MN 55379-1322
(612) 280-3048
Mailing address
17439 ISLETON AVE, LAKEVILLE, MN 55044-9693
(612) 280-3048
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
15625
MN
1041C0700X
Clinical Social Worker
9015-123
WI
Other
Enumeration date
03/01/2007
Last updated
06/04/2024
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