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General NPI Number Information
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NPI Number | 1770877318
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Entity Type | Organization
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Legal Business Name | HANSEN-COHEN ASSOCIATES IN PSYCHOLOGY, INC
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Dates
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Enumeration Date | 05/31/2011
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Last Update Date | 05/31/2011
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Provider Practice Location Address
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Address Line | 4301 VERONICA S SHOEMAKER BLVD STE B
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City | FORT MYERS
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State | FL
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Zip | 33916-2216
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Country | US
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Telephone | 239-274-7792
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Fax | 239-247-5344
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Provider Business Mailing Address
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Address Line | 4301 VERONICA S SHOEMAKER BLVD STE B
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City | FORT MYERS
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State | FL
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Zip | 33916-2216
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Country | US
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Telephone | 239-274-7792
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Fax | 239-247-5344
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Authorized Official
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Title or Position | PRESIDENT/LICENSED PSYCHOLOGIST
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Name | DR. CHRISTINA MARIE HANSEN
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Credential | PSY.D.
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Telephone | 239-274-7792
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY7935
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License Number State | FL
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