Individual
MR. DAVID EDWARD HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A., L.C.P.C, R.N.
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
180.003760
IL
101YP2500X
Professional Counselor
Primary
180003760
IL
163WP0808X
Psychiatric/Mental Health Registered Nurse
041206221
IL
Other
Enumeration date
02/16/2007
Last updated
11/24/2010
Update your record
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