Individual
DR. MICHAEL H. HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
3860 W OGDEN AVE, CHICAGO, IL 60623-2460
(773) 843-3000
(773) 843-2704
Mailing address
5001 HIGHWAY190, SUITE B1, COVINGTON, LA 70433
(985) 590-5744
Taxonomy
Speciality
Code
Description
License number
State
103TP0016X
Prescribing (Medical) Psychologist
Primary
MP.0017
LA
Other
Enumeration date
05/31/2006
Last updated
05/01/2012
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