Individual
ALYSSA GRACE HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, IBCLC
Contact information
Practice address
3641 LANCASTER AVE, PHILADELPHIA, PA 19104-2603
(267) 417-9525
Mailing address
2512 E CUMBERLAND ST, PHILADELPHIA, PA 19125-3107
(267) 417-9525
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
SW130660
PA
1041C0700X
Clinical Social Worker
Primary
CW019247
PA
174N00000X
Lactation Consultant (Non-RN)
L-316831
—
Other
Enumeration date
04/09/2016
Last updated
01/20/2025
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