| NPI | 1225906761 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIN LEIGH HANSEN Owner/Provider 508-450-0428 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-10-27 |
| Last Update Date | 2025-10-27 |