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1831329549
MICHAEL JAY HANSON
FARGO, ND
NPI
1831329549
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: MN 302532)
Enumeration Date
2009-07-16
Last Update Date
2009-07-16
Business Address
MICHAEL JAY HANSON LADC
1202 23RD STREET SOUTH
FARGO, ND 58103
Phone number: 701-293-5429
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Mailing Address
MICHAEL JAY HANSON LADC
1202 23RD STREET SOUTH
FARGO, ND 58103
Phone number: 701-293-5429
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