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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