Individual
KIMBERLY DEAN HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AT
Contact information
Practice address
1302 E VAUGHN AVE, GILBERT, AZ 85234-1015
(480) 980-8740
Mailing address
1302 E VAUGHN AVE, GILBERT, AZ 85234-1015
(480) 980-8740
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1214
AZ
Other
Enumeration date
05/02/2016
Last updated
05/02/2016
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