Basic Information
| Provider Information | |||||||||
| NPI: | 1780029421 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HANSEN & ASSOCIATES, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4028 RANGEVIEW DR | ||||||||
| Address2: | |||||||||
| City: | CHEYENNE | ||||||||
| State: | WY | ||||||||
| PostalCode: | 820012251 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3072148415 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1914 THOMES AVE | ||||||||
| Address2: | |||||||||
| City: | CHEYENNE | ||||||||
| State: | WY | ||||||||
| PostalCode: | 820013527 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3076319931 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/08/2013 | ||||||||
| LastUpdateDate: | 05/08/2013 | ||||||||
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| AuthorizedOfficialLastName: | JOHNSON | ||||||||
| AuthorizedOfficialFirstName: | ROBERT | ||||||||
| AuthorizedOfficialMiddleName: | FRANK | ||||||||
| AuthorizedOfficialTitleorPosition: | PROVISIONAL PROFESSIONAL COUNSELOR | ||||||||
| AuthorizedOfficialTelephone: | 3072148415 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNameSuffix: | SR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | PPC-735 | WY | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor |
No ID Information.