Individual
THERESSA J HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1701 BURNT BOAT DR, SECOND FLOOR, BISMARCK, ND 58503-0812
(701) 323-0924
(701) 323-0935
Mailing address
1701 BURNT BOAT DR, SECOND FLOOR, BISMARCK, ND 58503-0812
(701) 323-0924
(701) 323-0935
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
370
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12974
—
ND
01
—
HAN27931
BCBS OF ND
ND
01
—
P00189591
RR MEDICARE
ND
Enumeration date
01/23/2007
Last updated
01/28/2008
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