Individual
PAUL HANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11120 S CROWN WAY STE 1, WELLINGTON, FL 33414-8718
(561) 790-1191
Mailing address
16885 W YORKSHIRE DR, LOXAHATCHEE, FL 33470-3749
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY4391
FL
Other
Enumeration date
03/07/2019
Last updated
03/07/2019
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