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NPI Code Detail

MEDICARE: BRENT HANSEN

MEDICARE: BRENT HANSEN
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
1101YP2500XProfessional CounselorPC007570PA

General Provider Information

NPI Number : 1740698406
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRENT HANSEN
Provider Business Mailing Address
First Line : 5250 CASTE DR
Second Line :
City : PITTSBURGH
State : PA
Zip : 15236-1502
Country : US
Telephone Number : 412-885-7017
Fax Number :
Provider Business Practice Location Address
First Line : 5250 CASTE DR
Second Line :
City : PITTSBURGH
State : PA
Zip : 15236-1502
Country : US
Telephone Number : 412-885-7017
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2014
Last Update Date : 07/25/2014

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Directions to “ BRENT HANSEN ” Practice Location

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