Provider Demographics
NPI:1265128813
Name:KNUDSEN, HANNA MARIE (PCLC)
Entity type:Individual
Prefix:MS
First Name:HANNA
Middle Name:MARIE
Last Name:KNUDSEN
Suffix:
Gender:F
Credentials:PCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:906 GROUSE BERRY ST
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59106-8548
Mailing Address - Country:US
Mailing Address - Phone:541-531-7968
Mailing Address - Fax:
Practice Address - Street 1:101 E MENDENHALL ST STE H
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-3680
Practice Address - Country:US
Practice Address - Phone:406-595-3746
Practice Address - Fax:406-578-1363
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-17
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBHPCLCLIC57631101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health