Provider Demographics
NPI:1841563889
Name:BARBARA A. HANSON, PH.D., PA
Entity Type:Organization
Organization Name:BARBARA A. HANSON, PH.D., PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:A
Authorized Official - Last Name:HANSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LP
Authorized Official - Phone:651-482-9361
Mailing Address - Street 1:900 LONG LAKE RD STE 320
Mailing Address - Street 2:
Mailing Address - City:NEW BRIGHTON
Mailing Address - State:MN
Mailing Address - Zip Code:55112-6439
Mailing Address - Country:US
Mailing Address - Phone:651-482-9361
Mailing Address - Fax:651-482-9888
Practice Address - Street 1:900 LONG LAKE RD STE 320
Practice Address - Street 2:
Practice Address - City:NEW BRIGHTON
Practice Address - State:MN
Practice Address - Zip Code:55112-6439
Practice Address - Country:US
Practice Address - Phone:651-482-9361
Practice Address - Fax:651-482-9888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-22
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP1779103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty