Individual
SANDRA JEAN HANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
111 7TH ST S, MOORHEAD, MN 56560-2738
(218) 287-2089
(218) 291-1250
Mailing address
111 7TH ST S, MOORHEAD, MN 56560-2738
(218) 287-2089
(218) 291-1250
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
300070
MN
Other
Enumeration date
03/07/2017
Last updated
03/07/2017
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