Individual
ALISSA HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
51728 INDIANA STATE ROUTE 933, SOUTH BEND, IN 46637-1706
(574) 298-0962
Mailing address
150 SYLVAN GLEN DR, SOUTH BEND, IN 46615-3115
(574) 334-1118
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
34008218A
IN
Other
Enumeration date
01/19/2015
Last updated
11/10/2021
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