MEDICARE: DR. MEGHAN HANSEN PH.D.

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
1	103T00000X	Psychologist

General Provider Information

NPI Number	:	1144701137
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MEGHAN HANSEN PH.D.

Provider Business Mailing Address
First Line	:	4351 HUGH HOWELL RD # 1192
Second Line	:
City	:	TUCKER
State	:	GA
Zip	:	30084-4721
Country	:	US
Telephone Number	:	770-872-6788
Fax Number	:

Provider Business Practice Location Address
First Line	:	4351 HUGH HOWELL RD # 1192
Second Line	:
City	:	TUCKER
State	:	GA
Zip	:	30084-4721
Country	:	US
Telephone Number	:	770-872-6788
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2018
Last Update Date	:	06/05/2026

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