Hanson, Connie
Hanson, Connie is an individual health care provider with primary practice located at 14 Pacella Park Dr , Randolph MA 02368-1756. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Hanson, Connie can be contacted via phone (781) 437-1358.Contact Information
Primary practice address
14 Pacella Park Dr
Randolph MA 02368-1756
Phone: (781) 437-1358
Fax: (781) 437-1220
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X |
Profile Details
| NPI number | 1205171428 |
|---|---|
| LBN Legal business name | Hanson, Connie |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 28th, 2012 |
| Last updated | Nov 28th, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1205171428 | NPPES |
| Massachusetts | MEDICAID | 110026265 |
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