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Individual

EMILY R HANSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
44 DALE RD, SUITE 203, AVON, CT 06001-3612
(860) 674-1713
(860) 674-1848
Mailing address
27 DEPOT ST, WATERTOWN, CT 06795-2601
(860) 274-4092
(860) 274-4099

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
008026
CT
225100000X
Physical Therapist
Primary
9508
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080008026CT01
ANTHEM BCBS
CT
Enumeration date
05/14/2007
Last updated
12/12/2013
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