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NPI Code Detail

MEDICARE: DR. KRISTIN LANG HANSEN PH.D.

MEDICARE: DR. KRISTIN LANG 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
1103TC0700XClinical Psychologist62659972501UT

General Provider Information

NPI Number : 1548537749
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KRISTIN LANG HANSEN PH.D.
Provider Business Mailing Address
First Line : 4505 S WASATCH BLVD STE 290
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84124-4204
Country : US
Telephone Number : 385-695-5949
Fax Number :
Provider Business Practice Location Address
First Line : 4505 S WASATCH BLVD STE 290
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84124-4204
Country : US
Telephone Number : 385-695-5949
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2011
Last Update Date : 08/26/2025

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