Individual
MARK HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYCHOLOGIST
Contact information
Practice address
510 4TH ST S, FARGO, ND 58103-1914
(701) 476-7208
(701) 476-7261
Mailing address
510 4TH ST S, FARGO, ND 58103-1914
(701) 476-7208
(701) 476-7261
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
409
ND
Other
Enumeration date
04/09/2008
Last updated
04/09/2008
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