Individual
HOPE LANE HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1033 S 3RD ST, SAINT MARIES, ID 83861-8386
(208) 596-0014
Mailing address
1033 S 3RD ST, SAINT MARIES, ID 83861-1909
(208) 596-0014
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-1082
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
92-1734984
MASSAGE THERAPIST
ID
Enumeration date
01/18/2023
Last updated
03/12/2024
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