| NPI | 1104436559 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA D HANSON Owner And Therapist 385-355-4505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| 101YP2500X Counselor Professional | |
| Enumeration Date | 2020-07-31 |
| Last Update Date | 2020-07-31 |