Individual
GWEN R'DENE HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
3600 W 7TH ST, FORT WORTH, TX 76107-2534
(817) 377-3422
(817) 735-8615
Mailing address
2344 FOX GLENN CIR, BEDFORD, TX 76021-2670
(817) 377-3422
(817) 735-8615
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
109562
TX
Other
Enumeration date
02/02/2007
Last updated
07/08/2007
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