Doctor Name: | MIRIAM A HANSEN |
NPI Number: | 1043288830 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MFT |
License Number: | 270873-3902 |
Business Practice Address: | 5691 S Redwood Rd Suite #15 Taylorsville, UT - 841235322 |
Business Phone Number: | 8012814084 |
Business Fax Number: | 8012814083 |
Mailing Address: | 5691 S Redwood Rd, Suite #15 TAYLORSVILLE |
State: | UT |
Postal Code: | 841235322 |
Phone Number: | 8012814084 |
Fax Number: | 8012814083 |
NPI Enumeration Date: | 03/09/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 270873-3902 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |