Individual
MS. MARY BETH HANSON
Active
Individual
MS. MARY BETH HANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.I.S.W.
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
00742
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
099333000
MAGELLAN HEALTH VENDOR NU
IA
05
—
1143784
—
IA
Enumeration date
01/11/2006
Last updated
11/06/2019
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