Individual
JACOB HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PCLC
Contact information
Practice address
210 N HIGGINS AVE STE 222, MISSOULA, MT 59802-4443
(406) 351-6504
Mailing address
734 N 5TH ST W, MISSOULA, MT 59802-2814
(406) 396-6067
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
BBH-LCPC-LIC-62388
MT
Other
Enumeration date
06/16/2021
Last updated
08/28/2024
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