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General NPI Number Information
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NPI Number | 1902825698
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Entity Type | Individual
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Provider Name | LYNN HANSEN LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 01/04/2008
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Provider Practice Location Address
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Address Line | 6416 S HOWELL AVE
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City | OAK CREEK
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State | WI
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Zip | 53154-1104
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Country | US
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Telephone | 414-762-5429
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Fax |
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Provider Business Mailing Address
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Address Line | 285 N JANACEK RD
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City | BROOKFIELD
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State | WI
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Zip | 53045-6102
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Country | US
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Telephone |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 7195-123
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License Number State | WI
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