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Individual

TERESA LYNN HANSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, LPC

Contact information

Practice address
211 E COEUR D ALENE AVE, COEUR D ALENE, ID 83814-4926
(208) 699-6817
Mailing address
1839 N WOLFE PENN ST, LIBERTY LAKE, WA 99019-5058
(509) 843-7208

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YM0800X
Mental Health Counselor
Primary
101YP2500X
Professional Counselor

Other

Enumeration date
10/27/2020
Last updated
10/27/2020
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