Provider Demographics
NPI:1003434077
Name:HANSEN, ALIANDRIA (MT-BC)
Entity Type:Individual
Prefix:
First Name:ALIANDRIA
Middle Name:
Last Name:HANSEN
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1126 S SUGAR MAPLE CT
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47403-4566
Mailing Address - Country:US
Mailing Address - Phone:801-822-9233
Mailing Address - Fax:
Practice Address - Street 1:515 S WOODSCREST DR STE B
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47401-5303
Practice Address - Country:US
Practice Address - Phone:812-929-6061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-07
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist