Wilkerson Hansen, Genevieve Marie

Wilkerson Hansen, Genevieve Marie is an sole proprietor health care provider with primary practice located at 146 N 4Th W , Rexburg ID 83440-1415. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Behavior Technician, Respite Care Facility / Respite Care, Mental Retardation and/or Developmental Disabilities. Behavioral Health & Social Service Providers / Behavior Technician is her primary health care specialty. Wilkerson Hansen, Genevieve Marie can be contacted via phone (707) 815-3858.

Contact Information

Primary practice address
146 N 4Th W Rexburg ID 83440-1415
Phone: (707) 815-3858
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X
Respite Care Facility / Respite Care, Mental Retardation and/or Developmental Disabilities 385HR2060X

Profile Details

NPI number 1154922045
LBN Legal business name Wilkerson Hansen, Genevieve Marie
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 5th, 2020
Last updated Aug 10th, 2021 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154922045 NPPES
Idaho MEDICAID A0009285
Idaho MEDICAID A0009299

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