Most Relevant Information
Provider Data
| NPI Number: | 1003424383 |
| Provider Name: | CIARA HANSEN PHD |
| Entity Type: | Individual |
| Taxonomy Code: | 103TC0700X |
| Specialty: | Psychologist |
| License Number: | PSY-005220 |
Most Important Dates
| Enumeration Date: | 07/22/2020 |
| Last Updated: | 07/22/2020 |
Provider Practice Location
US- 491
SHIPROCK
NM
87420
Practice Location Phone/Fax
| Phone: | 5053686001 |
| Fax: |
Provider Mailing Location
6327 CLUB HOUSE DR
FARMINGTON
NM
874024457
Provider Mailing Phone/Fax
| Phone: | 4065467554 |
| Fax: |