Provider Information for 1396970893
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Mrs. SALLY E HANSEN MS, LIMHP
Sex: Female
NPI: 1396970893
Last Updated: 2023-08-03
Certification Date: 2023-08-03
Certification Date: 2023-08-03
Details
| Name | Value | ||||||||||||
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| NPI | 1396970893 | ||||||||||||
| Enumeration Date | 2009-05-27 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 5814 S 142ND ST OMAHA, NE 68137-2853 United States Phone: 531-466-4696 | Fax: | ||||||||||||
| Primary Practice Address | 5814 S 142ND ST OMAHA, NE 68137-2853 United States Phone: 531-466-4696 | Fax: | ||||||||||||
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