Individual
BRIAN JAMES HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, CADC
Contact information
Practice address
502 S MORRIS AVE, BLOOMINGTON, IL 61701-4884
(309) 820-7616
Mailing address
1805 MARINA DR, NORMAL, IL 61761-9340
(309) 530-5326
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/11/2021
Last updated
05/11/2021
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