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Individual

TIMOTHY HANSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1394 JACKSON ST STE 300, SAINT PAUL, MN 55117-4669
(651) 478-7815
Mailing address
7235 GUIDER DR APT 105, WOODBURY, MN 55125-5344
(651) 361-0025

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
304742
MN

Other

Enumeration date
03/31/2020
Last updated
12/07/2023
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