| Doctor Name: | MRS. MARILSA HANSEN |
| NPI Number: | 1770926446 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | 4572-125 |
| Business Practice Address: | 6320 Monona Dr Monona, WI - 537163952 |
| Business Phone Number: | 6084679074 |
| Business Fax Number: | |
| Mailing Address: | 5203 N Autumn Ln, MC FARLAND |
| State: | WI |
| Postal Code: | 535588612 |
| Phone Number: | 6088387931 |
| Fax Number: | |
| NPI Enumeration Date: | 04/12/2013 |
| NPI Last Update Date: | 04/12/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | 4572-125 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |