Individual
DOREEN JOY HANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
19190 N RIDGE RD, DETROIT LAKES, MN 56501-7650
(320) 305-1524
Mailing address
19190 N RIDGE RD, DETROIT LAKES, MN 56501-7650
(320) 305-1524
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
1078276-1-HCBS
MN
385H00000X
Respite Care
Primary
1078862-1-AFC
MN
Other
Enumeration date
12/07/2015
Last updated
12/07/2015
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