Individual
CYNTHIA HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BHS
Contact information
Practice address
237 E 6TH ST, RUSSELLVILLE, KY 42276-1917
(270) 726-3629
(270) 726-3620
Mailing address
540 S MAIN ST, RUSSELLVILLE, KY 42276-2014
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30604011
—
KY
Enumeration date
05/30/2007
Last updated
07/08/2007
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