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Individual

ROBERT G HANSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
ONE ST FRANCIS DRIVE, 9TH FLOOR, GREENVILLE, SC 29601
(864) 255-1563
(864) 255-1913
Mailing address
1300 SHAW RD, WOODRUFF, SC 29388
(864) 313-7911

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
563
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
563
SC PSYCH
Enumeration date
10/24/2006
Last updated
07/08/2007
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