Provider Demographics
NPI:1205372554
Name:JENNY HANSON THERAPY LLC
Entity Type:Organization
Organization Name:JENNY HANSON THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:JILL
Authorized Official - Last Name:HANSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:214-458-0286
Mailing Address - Street 1:1901 N CENTRAL EXPY
Mailing Address - Street 2:SUITE 220
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-3558
Mailing Address - Country:US
Mailing Address - Phone:214-233-5470
Mailing Address - Fax:972-680-9216
Practice Address - Street 1:1901 N CENTRAL EXPY
Practice Address - Street 2:SUITE 220
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3558
Practice Address - Country:US
Practice Address - Phone:214-233-5470
Practice Address - Fax:972-680-9216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-10
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73297101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty