Individual
CONNIE L HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1313 FISH HATCHERY RD, MADISON, WI 53715-1911
(608) 260-6004
(608) 283-7160
Mailing address
1313 FISH HATCHERY RD, MADISON, WI 53715-1911
(608) 260-6004
(608) 283-7160
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
935026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1841468055
—
WI
Enumeration date
02/11/2008
Last updated
12/18/2020
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