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Individual

TYSON HANSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1720 N WESTGATE DR, SUITE A-1, BOISE, ID 83704-7164
(208) 334-0855
Mailing address
230 DAVIS AVE, NAMPA, ID 83651-2007

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary

Other

Enumeration date
05/16/2016
Last updated
05/16/2016
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