Organization
SHELLEY K HANSEN, LSW, MA, LP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLEY KAY HANSEN LSW,MA, LP (OWNER)
(612) 532-6741
Entity
Organization
Contact information
Practice address
105 EAST FOURTH STREET, SUITE 302, NORTHFIELD, MN 55057-2050
(612) 532-6741
Mailing address
105 EAST FOURTH STREET, SUITE 302, NORTHFIELD, MN 55057-2050
(612) 532-6741
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP3954
MN
1041C0700X
Clinical Social Worker
LSW5063
MN
Other
Enumeration date
02/04/2013
Last updated
04/02/2014
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