| NPI | 1356502389 |
|---|---|
| Former Name | SHANNON L HANSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TN 53315) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC LL30894) |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2024-01-17 |