Provider Demographics
NPI:1770321309
Name:HANSEN, REBECCA HATCH (MS)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:HATCH
Last Name:HANSEN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 W ELEPHANT HEAD RD
Mailing Address - Street 2:
Mailing Address - City:GREEN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85622-6406
Mailing Address - Country:US
Mailing Address - Phone:520-507-1546
Mailing Address - Fax:
Practice Address - Street 1:3850 W ORANGE GROVE RD STE 3
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-2869
Practice Address - Country:US
Practice Address - Phone:520-886-1136
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health