Individual
CHARLEY HANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3113 W BELTLINE HWY STE 300, MADISON, WI 53713-2934
(608) 819-6810
(608) 819-6811
Mailing address
3113 W BELTLINE HWY STE 300, MADISON, WI 53713-2934
(608) 819-6810
(608) 819-6811
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-21-162361
WI
Other
Enumeration date
08/09/2021
Last updated
08/09/2021
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