Individual
CASEY HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4055 N PARK LOOP, MEMPHIS, TN 38152-8751
(901) 678-2009
(901) 678-5497
Mailing address
1227 GRACE ANN CT, CORDOVA, TN 38016-8751
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q067513
—
TN
Enumeration date
01/05/2021
Last updated
08/04/2021
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