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General NPI Number Information
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NPI Number | 1891982740
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Entity Type | Individual
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Provider Name | JUDITH HUNTER HANSON LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/25/2007
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Last Update Date | 09/25/2007
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Provider Practice Location Address
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Address Line | 113 N 2ND AVE
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City | ST CHARLES
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State | IL
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Zip | 60174-1912
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Country | US
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Telephone | 630-254-9027
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Fax | 630-377-9101
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Provider Business Mailing Address
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Address Line | PO BOX 303
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City | LAFOX
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State | IL
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Zip | 60147-0303
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Country | US
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Telephone | 630-254-9027
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Fax | 630-377-9101
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State | IL
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