Individual
MRS. BRADIE ANN HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
174 BATTERY ST STE 2, BURLINGTON, VT 05401-6201
(802) 985-3603
Mailing address
74 TRILLIUM LN, SHELBURNE, VT 05482-6405
(802) 985-3603
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
047.0000712
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1010473
—
VT
01
—
2232080
CIGNA BEHAVIORAL HEALTH
VT
01
—
68032
BCBS OF VERMONT
VT
Enumeration date
03/30/2007
Last updated
05/25/2019
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