Organization
CLINICAL & NEUROPSYCHOLOGICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID EDWARD HANSEN PHD (OWNER)
(918) 712-9004
Entity
Organization
Contact information
Practice address
5512 S LEWIS AVE, SUITE 8, TULSA, OK 74105-7140
(918) 712-9004
Mailing address
5512 S LEWIS AVE, SUITE 8, TULSA, OK 74105-7140
(918) 712-9004
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
849
OK
Other
Enumeration date
03/26/2014
Last updated
03/26/2014
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