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1487000949
JORDAN HANSEN
SAINT PAUL, MN
NPI
1487000949
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MN 303530)
Enumeration Date
2016-05-13
Last Update Date
2016-05-13
Business Address
-- JORDAN HANSEN LADC
1123 GRAND AVE STE 103
SAINT PAUL, MN 55105-2629
Phone number: 612-500-1269
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Mailing Address
-- JORDAN HANSEN LADC
1123 GRAND AVE STE 103
SAINT PAUL, MN 55105-2629
Phone number: 612-500-1269
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