Individual
DR. BRIAN HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
125 EAST 300 SOUTH SUITE 207, PROVO, UT 84606-5156
(801) 477-6940
Mailing address
993 EAST 300 SOUTH, PROVO, UT 84606-5156
(801) 310-2133
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
8918949-2501
UT
Other
Enumeration date
07/26/2010
Last updated
09/02/2016
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