Provider Demographics
NPI:1982252706
Name:HANSON, TAGE FRANCES
Entity type:Individual
Prefix:
First Name:TAGE
Middle Name:FRANCES
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 1:1224 S 3RD ST # 57401
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:SD
Mailing Address - Zip Code:57401-6920
Mailing Address - Country:US
Mailing Address - Phone:605-725-7100
Mailing Address - Fax:
Practice Address - Street 1:414 S 10TH ST # 57401
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:SD
Practice Address - Zip Code:57401-3856
Practice Address - Country:US
Practice Address - Phone:605-725-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-27
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD864-PROV235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist