Provider Demographics
NPI:1629055413
Name:HANSEN, BARBARA MARIE (MSW)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:MARIE
Last Name:HANSEN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5905 CEDAR RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-8791
Mailing Address - Country:US
Mailing Address - Phone:734-558-3575
Mailing Address - Fax:734-930-0083
Practice Address - Street 1:6360 JACKSON RD
Practice Address - Street 2:SUITE M
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-9597
Practice Address - Country:US
Practice Address - Phone:734-558-3575
Practice Address - Fax:734-930-0083
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010596221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical