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General NPI Number Information
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NPI Number | 1891358990
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Entity Type | Individual
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Provider Name | JAIME HANSEN
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Gender | Female
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Dates
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Enumeration Date | 04/15/2019
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Last Update Date | 06/07/2021
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Provider Practice Location Address
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Address Line | 80 GARDEN CTR STE 156
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City | BROOMFIELD
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State | CO
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Zip | 80020-1790
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Country | US
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Telephone | 319-491-3836
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Fax |
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Provider Business Mailing Address
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Address Line | 5674 SIMMS ST APT 102
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City | ARVADA
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State | CO
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Zip | 80002-2080
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Country | US
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Telephone | 780-405-4161
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC.0014605
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License Number State | CO
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