Individual
KELSIE MARY HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4725 AMBER VALLEY PKWY S STE B, FARGO, ND 58104-8614
(701) 478-0221
(701) 478-0222
Mailing address
4725 AMBER VALLEY PKWY S STE B, FARGO, ND 58104-8614
(701) 478-0221
(701) 478-0222
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
174400000X
Specialist
RBT-23-279466
ND
Other
Enumeration date
06/19/2023
Last updated
06/20/2023
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