Basic Information
| Provider Information | |||||||||
| NPI: | 1245676998 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HANSON | ||||||||
| FirstName: | JULIA | ||||||||
| MiddleName: | |||||||||
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| NameSuffix: | |||||||||
| Credential: | LMSW | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | GALEA | ||||||||
| OtherFirstName: | JULIA | ||||||||
| OtherMiddleName: | |||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 35613 VALLEY CRK. | ||||||||
| Address2: | |||||||||
| City: | FARMINGTON HILLS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48335 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2484771557 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 27941 HARPER AVE. | ||||||||
| Address2: | SUITE 105 | ||||||||
| City: | ST. CLAIR SHORES | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48081 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5867773200 | ||||||||
| FaxNumber: | 5867777855 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/21/2013 | ||||||||
| LastUpdateDate: | 05/21/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 6801082545 | MI | N | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041S0200X | 6801082545 | MI | Y | Behavioral Health & Social Service Providers | Social Worker | School |
No ID Information.