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General NPI Number Information
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NPI Number | 1659363414
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Entity Type | Individual
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Provider Name | LAURA E. HANSEN L.P.C.
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Gender | Female
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Dates
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Enumeration Date | 08/18/2005
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Last Update Date | 02/25/2016
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Provider Practice Location Address
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Address Line | 600 TX- 349
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City | IRAAN
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State | TX
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Zip | 79744
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Country | US
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Telephone | 432-639-2575
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Fax | 432-639-6292
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Provider Business Mailing Address
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Address Line | PO BOX 12032
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City | ODESSA
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State | TX
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Zip | 79768-2032
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Country | US
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Telephone | 432-288-8357
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Fax |
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 13625
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License Number State | TX
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