Healthcare Provider Details

I. General information

NPI: 1982114104
Provider Name (Legal Business Name): CORTNEY CHRISTINE HANSEN SSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2017
Last Update Date: 08/12/2021
Certification Date: 08/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 W 600 N
TREMONTON UT
84337-2400
US

IV. Provider business mailing address

3130 W 11300 N
DEWEYVILLE UT
84309-9719
US

V. Phone/Fax

Practice location:
  • Phone: 435-257-2168
  • Fax:
Mailing address:
  • Phone: 385-231-3945
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: