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Individual

EMILY ROSE HANSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1405 PRAIRIE PKWY STE 309, WEST FARGO, ND 58078-3323
(701) 277-8844
Mailing address
347 13TH AVE E, WEST FARGO, ND 58078
(701) 277-8844
(701) 277-8847

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
106S00000X
Behavior Technician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1437321189
TRICARE
Enumeration date
12/18/2017
Last updated
02/20/2023
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