Provider Demographics
NPI:1396161147
Name:HANSEN, JOAN
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:
Last Name:HANSEN
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 1:3170 N FEDERAL HIGHAY
Mailing Address - Street 2:SUITE 115
Mailing Address - City:LIGHTHOUSE POINT
Mailing Address - State:FL
Mailing Address - Zip Code:33064-6721
Mailing Address - Country:US
Mailing Address - Phone:954-943-9020
Mailing Address - Fax:954-943-9036
Practice Address - Street 1:3170 N FEDERAL HIGHAY
Practice Address - Street 2:SUITE 115
Practice Address - City:LIGHTHOUSE POINT
Practice Address - State:FL
Practice Address - Zip Code:33064-6721
Practice Address - Country:US
Practice Address - Phone:954-943-9020
Practice Address - Fax:954-943-9036
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-17
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS1430237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist