Individual
ROBERT HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
2701 12TH AVE S, FARGO, ND 58103-8753
(701) 451-4900
(651) 925-0057
Mailing address
2701 12TH AVE S, FARGO, ND 58103-8753
(701) 451-4900
(651) 925-0057
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1736
ND
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
Other
Enumeration date
07/14/2014
Last updated
03/04/2024
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