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General NPI Number Information
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NPI Number | 1205372554
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Entity Type | Organization
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Legal Business Name | JENNY HANSON THERAPY LLC
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Dates
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Enumeration Date | 01/10/2017
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Last Update Date | 01/10/2017
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Provider Practice Location Address
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Address Line | 1901 N CENTRAL EXPY SUITE 220
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City | RICHARDSON
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State | TX
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Zip | 75080-3558
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Country | US
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Telephone | 214-233-5470
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Fax | 972-680-9216
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Provider Business Mailing Address
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Address Line | 1901 N CENTRAL EXPY SUITE 220
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City | RICHARDSON
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State | TX
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Zip | 75080-3558
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Country | US
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Telephone | 214-233-5470
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Fax | 972-680-9216
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | JENNIFER JILL HANSON
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Credential | LPC
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Telephone | 214-458-0286
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 73297
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License Number State | TX
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