Individual
PAMELA JO HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CASE MANAGER
Contact information
Practice address
540 3RD ST, IDAHO FALLS, ID 83401-3953
(208) 524-5607
Mailing address
540 3RD ST, IDAHO FALLS, ID 83401-3953
(208) 524-5607
(208) 524-0636
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
12/04/2023
Last updated
12/04/2023
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