Individual
MARK HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1455 SAINT FRANCIS AVE, SHAKOPEE, MN 55379-3374
(952) 428-4062
Mailing address
513 GOOSEBERRY LN, DUNDAS, MN 55019-3978
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CC01712
MN
Other
Enumeration date
05/12/2016
Last updated
02/13/2018
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