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Individual

MR. KERRY MICHAEL HANSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
805 TIJERAS AVE NW, ALBUQUERQUE, NM 87102-3099
(505) 242-1010
(503) 944-2595
Mailing address
2617 HAGLAND PL NE, ALBUQUERQUE, NM 87112-1920
(505) 242-1010

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary

Other

Enumeration date
01/29/2007
Last updated
07/22/2011
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