Organization
JOHN HANSEN M.A. LICENSED PSYCHOLOGIST LLC
Active
Organization
JOHN HANSEN M.A. LICENSED PSYCHOLOGIST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN HANSEN M.A. (LICENSED PSYYCHOLOGIST)
(651) 434-3325
Entity
Organization
Contact information
Practice address
1600 UNIVERSITY AVE W, SUITE 400, SAINT PAUL, MN 55104-3898
(651) 434-3325
Mailing address
1600 UNIVERSITY AVE W, SUITE 400, SAINT PAUL, MN 55104-3898
(651) 434-3325
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
LP 3679
MN
103TC0700X
Clinical Psychologist
Primary
LP 3679
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
795217100
—
MN
Enumeration date
09/11/2009
Last updated
09/11/2009
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