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Organization

STACIA HANSON MA LP LLC

Active
Other names
Lilium Center
Organization subpart
No

Provider details

NPI number
Authorized official
STACIA HANSON MA LP (CEO, OWNER)
(952) 921-3266
Entity
Organization

Contact information

Practice address
7101 YORK AVE S SUITE 317, EDINA, MN 55435
(952) 921-3266
(651) 224-3765
Mailing address
7101 YORK AVE S SUITE 317, EDINA, MN 55435
(952) 921-3266
(651) 224-3765

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
103TC0700X
Clinical Psychologist

Other

Enumeration date
02/28/2012
Last updated
09/29/2022
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