Individual
MRS. STACEY MAE HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
925 SULLIVAN AVE, UNIT 2, SOUTH WINDSOR, CT 06074-2025
(860) 432-7771
(860) 432-7774
Mailing address
925 SULLIVAN AVE, UNIT 2, SOUTH WINDSOR, CT 06074-2025
(860) 432-7771
(860) 432-7774
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
001227
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008025577
—
CT
Enumeration date
01/06/2009
Last updated
07/01/2015
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