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NPI Code Detail

MEDICARE: MRS. EMILY RANA HANSON LCDC, LPC-INTERN

MEDICARE:  MRS. EMILY RANA HANSON  LCDC, LPC-INTERN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor13824TX

General Provider Information

NPI Number : 1053831016
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. EMILY RANA HANSON LCDC, LPC-INTERN
Provider Business Mailing Address
First Line : 6315 TEN MILE BRIDGE RD
Second Line :
City : FORT WORTH
State : TX
Zip : 76135-1339
Country : US
Telephone Number : 817-800-0418
Fax Number :
Provider Business Practice Location Address
First Line : 1801 N RIVERSIDE DR
Second Line :
City : FORT WORTH
State : TX
Zip : 76111-2732
Country : US
Telephone Number : 817-601-8775
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2017
Last Update Date : 06/21/2017

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Directions to “ MRS. EMILY RANA HANSON LCDC, LPC-INTERN” Practice Location

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