| John Hansen M.a. Licensed Psychologist Llc | |
|
1600 University Ave W Suite 400 Saint Paul MN 55104-3898 | |
| (651) 434-3325 | |
| Not Available |
| Full Name | John Hansen M.a. Licensed Psychologist Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 1600 University Ave W, Saint Paul, Minnesota |
| Authorized Official Name and Position | John Hansen (LICENSED PSYYCHOLOGIST) |
| Authorized Official Contact | 6514343325 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| John Hansen M.a. Licensed Psychologist Llc 1600 University Ave W Suite 400 Saint Paul MN 55104-3898 Ph: (651) 434-3325 | John Hansen M.a. Licensed Psychologist Llc 1600 University Ave W Suite 400 Saint Paul MN 55104-3898 Ph: (651) 434-3325 |
| NPI Number | 1407189251 |
|---|---|
| Provider Enumeration Date | 09/11/2009 |
| Last Update Date | 09/11/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407189251 | NPI | - | NPPES |
| 795217100 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TB0200X | Psychologist - Cognitive & Behavioral | LP 3679 (Minnesota) | Secondary |
| 103TC0700X | Psychologist - Clinical | LP 3679 (Minnesota) | Primary |
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