Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 104100000X | Social Worker | SW126279 | PA |
Y | 1041C0700X | Clinical Social Worker | CW01732 | PA |
NPI | 1003192329 |
---|---|
Provider Name | Ms. Jennifer Christen Hanson |
First Address | York, PA 17403-1254 |
Second Address | York, PA 17403-1254 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2011 |
Last Update Date | 07/10/2014 |