Individual
AMBER NICHOLE HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
47 W 1124 N APT 2, LOGAN, UT 84341-6848
(435) 881-3519
Mailing address
47 W 1124 N APT 2, LOGAN, UT 84341-6848
(435) 881-3519
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-90611
UT
Other
Enumeration date
12/05/2019
Last updated
12/05/2019
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