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Individual

DR. PETER JOHN HANSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
2717 N GRANDVIEW BLVD, SUITE 110, WAUKESHA, WI 53188-1672
(414) 303-4205
Mailing address
2717 N GRANDVIEW BLVD, SUITE 110, WAUKESHA, WI 53188-1672
(414) 303-4205

Taxonomy

Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
2072057
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
39130500
WI
Enumeration date
10/13/2006
Last updated
06/20/2013
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