Provider Demographics
NPI:1225617939
Name:HANSEN, NANCY (MS IN EDUCATION)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:HANSEN
Suffix:
Gender:F
Credentials:MS IN EDUCATION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 SANFORD ST
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10307-1924
Mailing Address - Country:US
Mailing Address - Phone:347-680-0259
Mailing Address - Fax:
Practice Address - Street 1:22 SANFORD ST
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10307-1924
Practice Address - Country:US
Practice Address - Phone:347-680-0259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-08
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency