Healthcare Provider Details

I. General information

NPI: 1194558718
Provider Name (Legal Business Name): HANNAH WILSON BS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2024
Last Update Date: 02/20/2026
Certification Date: 02/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 US HIGHWAY 395 N STE 103
MINDEN NV
89423-4331
US

IV. Provider business mailing address

1218 ESTHER WAY
MINDEN NV
89423-8809
US

V. Phone/Fax

Practice location:
  • Phone: 775-309-3823
  • Fax:
Mailing address:
  • Phone: 775-309-3823
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMI4580
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: