Individual
MITCHEL PETERR HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1100 GLENWOOD AVE, MINNEAPOLIS, MN 55405-1430
(612) 871-1415
Mailing address
1100 GLENWOOD AVE, MINNEAPOLIS, MN 55405-1430
(612) 871-1415
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
3747P1801X
Personal Care Attendant
PCA30821820130822
MN
Other
Enumeration date
08/23/2013
Last updated
03/21/2019
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