Individual
MS. KIMM GLORIA HANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2490 W YOWELL CT UNIT 49, YUMA, AZ 85364-1735
(928) 539-9298
Mailing address
2490 W YOWELL CT UNIT 49, YUMA, AZ 85364-1735
(928) 539-9298
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
11133
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
085948
—
AZ
Enumeration date
12/19/2006
Last updated
07/09/2007
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