Hansen, Peter John
Hansen, Peter John is an individual health care provider with primary practice located at 2717 N Grandview Blvd Suite 110, Waukesha WI 53188-1672. He recently has only one registered license in Behavioral Health & Social Service Providers / Counseling, which is considered as his primary health care specialty. Hansen, Peter John can be contacted via phone (414) 303-4205.Contact Information
Primary practice address
2717 N Grandview Blvd Suite 110
Waukesha WI 53188-1672
Phone: (414) 303-4205
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Counseling | 103TC1900X | 2072057 | Wisconsin |
Profile Details
| NPI number | 1619067600 |
|---|---|
| LBN Legal business name | Hansen, Peter John |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 13th, 2006 |
| Last updated | Jun 20th, 2013 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619067600 | NPPES |
| Wisconsin | MEDICAID | 39130500 |
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