Individual
BRIAN HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
480 N. MAIN STREET, LEEDS, UT 84746-0993
(435) 879-6990
Mailing address
PO BOX 460993, 480 N. MAIN STREET, LEEDS, UT 84746-0993
(435) 879-6990
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
140877-3501
UT
Other
Enumeration date
08/12/2010
Last updated
08/17/2010
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