Individual
LACEY HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LPC
Contact information
Practice address
6 WAPITI LANE, ENNIS, MT 59729
(406) 451-1439
Mailing address
PO BOX 1221, ENNIS, MT 59729
(406) 451-1439
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1183
WY
101YM0800X
Mental Health Counselor
Primary
4593
MT
Other
Enumeration date
09/14/2009
Last updated
11/20/2013
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