Individual
MARY JANE HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
330 N GORE AVE, WEBSTER GROVES, MO 63119-1600
(314) 956-0101
Mailing address
772 DALLAS DR, SAINT LOUIS, MO 63125-1448
(502) 873-6327
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
2017026733
MO
Other
Enumeration date
08/24/2017
Last updated
08/24/2017
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