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Individual

VICTOR D HANSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LAC, BSW

Contact information

Practice address
1312 N MERIDIAN RD, KALISPELL, MT 59901-3095
(406) 756-6453
Mailing address
PO BOX 7115, KALISPELL, MT 59904-0115
(406) 756-6453

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1262
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1262
STATE LICENSE
MT
Enumeration date
06/03/2010
Last updated
06/03/2010
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