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Individual

TRACY M HANSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPCC

Contact information

Practice address
5147 44TH ST. S., FARGO, ND 58104-6069
(701) 239-2567
(701) 540-0587
Mailing address
5147 44TH ST. S., FARGO, ND 58104-6069
(701) 239-2567
(701) 540-0587

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
84261515298
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1470012
ND
05
1475235
ND
Enumeration date
01/11/2017
Last updated
09/06/2023
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