Individual
AMY SUE HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
11618 S STATE ST STE 1604, DRAPER, UT 84020-7123
(385) 202-5645
Mailing address
151 E MIDVILLAGE BLVD APT 117, SANDY, UT 84070-1204
(408) 857-9535
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
124687643502
UT
171M00000X
Case Manager/Care Coordinator
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Other
Enumeration date
08/07/2019
Last updated
12/02/2021
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