MEDICARE: ROCHELLE LOIS 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
1	101YP2500X	Professional Counselor		MN

General Provider Information

NPI Number	:	1790668192
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROCHELLE LOIS HANSEN

Provider Business Mailing Address
First Line	:	PO BOX 122
Second Line	:
City	:	LEEDS
State	:	ND
Zip	:	58346-0122
Country	:	US
Telephone Number	:	701-609-2985
Fax Number	:

Provider Business Practice Location Address
First Line	:	813 S POKEGAMA AVE LOWR LEVEL
Second Line	:
City	:	GRAND RAPIDS
State	:	MN
Zip	:	55744-3934
Country	:	US
Telephone Number	:	218-999-9432
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/31/2025
Last Update Date	:	07/31/2025

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Directions to “ ROCHELLE LOIS HANSEN ” Practice Location

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