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1275040271
SAMANTHA ROSE HANSEN
PROVO, UT
NPI
1275040271
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2017-12-29
Last Update Date
2017-12-29
Business Address
SAMANTHA ROSE HANSEN
151 S UNIVERSITY AVE
PROVO, UT 84601-4427
Phone number: 801-851-7127
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Mailing Address
SAMANTHA ROSE HANSEN
151 S UNIVERSITY AVE
PROVO, UT 84601-4427
Phone number: 801-851-7127
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