Hanson, Mollie Marie

Hanson, Mollie Marie is an individual health care provider with primary practice located at 2502 E Empire Ste C Midwest Regional Pain Center, Bloomington IL 61704. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Hanson, Mollie Marie can be contacted via phone (309) 663-7220.

Contact Information

Primary practice address
2502 E Empire Ste C Midwest Regional Pain Center Bloomington IL 61704
Phone: (309) 663-7220
Fax: (309) 664-6687
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X Illinois

Profile Details

NPI number 1952315772
LBN Legal business name Hanson, Mollie Marie
Credentials PSYD
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 28th, 2006
Last updated Jul 8th, 2007 - about 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952315772 NPPES
Illinois Other 112584 HEALTH ALLIANCE

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