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General NPI Number Information
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NPI Number | 1750919700
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Entity Type | Organization
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Legal Business Name | COLLEEN HANSON
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Dates
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Enumeration Date | 03/27/2020
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Last Update Date | 01/15/2022
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Provider Practice Location Address
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Address Line | 285 TAMARACK DR
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City | SALINE
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State | MI
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Zip | 48176-9573
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Country | US
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Telephone | 517-375-2380
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Fax |
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Provider Business Mailing Address
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Address Line | 285 TAMARACK DR
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City | SALINE
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State | MI
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Zip | 48176-9573
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Country | US
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Telephone | 517-375-2380
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | COLLEEN HANSON
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Credential | LPC
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Telephone | 517-375-2380
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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 |
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License Number State |
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