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NPI Code Detail

MEDICARE: REBECCA L HANSEN

MEDICARE: REBECCA L HANSEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist

General Provider Information

NPI Number : 1790202687
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA L HANSEN
Provider Business Mailing Address
First Line : 3319 N UNIVERSITY AVE STE 100
Second Line :
City : PROVO
State : UT
Zip : 84604-4447
Country : US
Telephone Number : 801-356-0014
Fax Number :
Provider Business Practice Location Address
First Line : 3319 N UNIVERSITY AVE STE 100
Second Line :
City : PROVO
State : UT
Zip : 84604-4447
Country : US
Telephone Number : 801-356-0014
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2017
Last Update Date : 01/02/2025

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Directions to “ REBECCA L HANSEN ” Practice Location

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