Individual
AMBER LEA HANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LN
Contact information
Practice address
2025 4TH ST, WHITE BEAR LAKE, MN 55110-2762
(612) 787-2281
Mailing address
3518 JOHNSON ST NE, MINNEAPOLIS, MN 55418-1413
(612) 245-1343
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
N228
MN
Other
Enumeration date
09/19/2018
Last updated
07/25/2019
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