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Individual

ANGELA LEIGH HANSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW, LCSW

Contact information

Practice address
403 W CHERRY LN, MERIDIAN, ID 83642-1610
(208) 887-1911
(208) 895-8049
Mailing address
403 W CHERRY LN, MERIDIAN, ID 83642-1610
(208) 887-1911
(208) 895-8049

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-34104
ID
1041C0700X
Clinical Social Worker
LCSW-884
WY

Other

Enumeration date
10/02/2012
Last updated
01/06/2016
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