Individual
MISS MIKAELA HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1135 N H ST, BROKEN BOW, NE 68822-1262
(308) 872-2982
Mailing address
1135 N H ST, BROKEN BOW, NE 68822-1262
(308) 872-2982
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
912
NE
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
07/21/2022
Last updated
07/21/2022
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