Individual
LORA SUE HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
1400 SUDDERTH DR, RUIDOSO, NM 88345-6103
(575) 630-0571
(575) 630-0574
Mailing address
1400 SUDDERTH DR, RUIDOSO, NM 88345-6103
(575) 630-0571
(575) 630-0574
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/22/2022
Last updated
03/29/2022
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