TRACIE LYN HANSEN

POCATELLO, ID
NPI1639779523
Former NameTRACIE LYN BURRUP
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy175T00000X Peer Specialist
(Licence: ID  CPSS055)
Enumeration Date2020-10-29
Last Update Date2023-04-10
Business Address
TRACIE LYN HANSEN B.S.
560 FAIRWAY DR
POCATELLO, ID 83201-2012
Phone number: 208-242-6669
Mailing Address
TRACIE LYN HANSEN B.S.
611 WILSON AVE STE 5
POCATELLO, ID 83201-5046
Phone number: 208-915-8448
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