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General NPI Number Information
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NPI Number | 1598204075
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Entity Type | Individual
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Provider Name | DANIELLE HANSEN LMSW
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Gender | Female
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Dates
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Enumeration Date | 02/17/2017
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Last Update Date | 02/17/2017
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Provider Practice Location Address
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Address Line | 432 KING DR
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City | WATERLOO
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State | IA
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Zip | 50702-5956
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Country | US
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Telephone | 319-272-6537
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Fax | 319-272-0058
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Provider Business Mailing Address
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Address Line | 432 KING DR
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City | WATERLOO
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State | IA
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Zip | 50702-5956
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Country | US
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Telephone | 319-272-6537
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Fax | 319-272-0058
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 081453
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License Number State | IA
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