Provider Demographics
NPI:1417285867
Name:HANSEN, LOIS ELAINE (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LOIS
Middle Name:ELAINE
Last Name:HANSEN
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 GARDEN HILL DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28739-6435
Mailing Address - Country:US
Mailing Address - Phone:828-808-9578
Mailing Address - Fax:
Practice Address - Street 1:188 GARDEN HILL DR
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28739-6435
Practice Address - Country:US
Practice Address - Phone:828-808-9578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-23
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2822235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist