Provider Demographics
NPI:1104573765
Name:HANSON, ALISHA
Entity type:Individual
Prefix:
First Name:ALISHA
Middle Name:
Last Name:HANSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300606 COUNTY ROAD H
Mailing Address - Street 2:
Mailing Address - City:MINATARE
Mailing Address - State:NE
Mailing Address - Zip Code:69356-4324
Mailing Address - Country:US
Mailing Address - Phone:307-363-3591
Mailing Address - Fax:
Practice Address - Street 1:300606 COUNTY ROAD H
Practice Address - Street 2:
Practice Address - City:MINATARE
Practice Address - State:NE
Practice Address - Zip Code:69356-4324
Practice Address - Country:US
Practice Address - Phone:307-363-3591
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-03
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist