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1871999888
SCOTT HANSEN
HAYDEN, ID
NPI
1871999888
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
222Q00000X Developmental Therapist
(Licence: ID DDA-999)
Enumeration Date
2014-11-18
Last Update Date
2016-10-20
Business Address
-- SCOTT HANSEN
8252 N WAYNE DR
HAYDEN, ID 83835-5029
Phone number: 219-263-3141
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Mailing Address
-- SCOTT HANSEN
8252 N WAYNE DR
HAYDEN, ID 83835-5029
Phone number: 219-263-3141
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