Susan Hansen, M.ED.
Individual provider Active NPI Developmental Therapist · Ponderay, ID
NPI 1801256227 · NPPES record last updated Feb 26, 2016
Key facts
- NPI
- 1801256227
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Developmental Therapist 222Q00000X
- Practice address
- 207 Larkspur St
Ponderay, ID 83852-5011 - Phone
- (208) 255-3304
- Fax
- (208) 263-4198
- NPI assigned
- Feb 26, 2016
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Education
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Idaho Dept of Health & Welfare Reg 1 Ahm PSR Sandpoint | Past | Accepting new patients | |
| Idaho Dept of Health & Welfare Reg 1 Amh Clinic Sandpoint | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | Yes |
Addresses
Primary practice location
207 Larkspur St
Ponderay, ID 83852-5011
Mailing address
207 Larkspur St
Ponderay, ID 83852-5011
Phone (208) 255-3304
Other providers in Ponderay, ID
- Kathy Gavin
- Glacier Prosthetic Care, Inc.
- Rebecca Goebel
- Sadie Green
- Michaella A. Hammersberg
- Debra Mae Haworth-Bush
- Tara Heisey
- Jessica Hunt
- Idaho Dept of Health & Welfare Reg 1 Ahm PSR Sandpoint
- Idaho Dept of Health & Welfare Reg 1 Amh Clinic Sandpoint
All providers in Ponderay, ID · Developmental Therapist in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 26, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.