Individual
CARLY J HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
1 COLOMBA DR STE 2, NIAGARA FALLS, NY 14305-1275
(315) 710-0080
Mailing address
1 COLOMBA DR STE 2, NIAGARA FALLS, NY 14305-1275
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
174N00000X
Lactation Consultant (Non-RN)
L-305402
NY
Other
Enumeration date
07/13/2021
Last updated
01/30/2026
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