person
Tracie Lyn Hansen, BS
Peer Specialist in Pocatello, Idaho
NPI 1639779523

Tracie Lyn Hansen is a Peer Specialist based in Pocatello, ID. Tracie Lyn Hansen practices in Pocatello, ID and has the professional credentials of BS. The NPI Number for Tracie Lyn Hansen is 1639779523 and holds a License No. CPSS055 (Idaho).

The current practice location address for Tracie Lyn Hansen is 560 Fairway Dr, Pocatello, ID and can be reached out via phone at 208-242-6669. You can also correspond with Tracie Lyn Hansen through the mailing address at 611 WILSON AVE STE 5, POCATELLO, ID - 83201-5046 (mailing address contact number: 208-915-8448).

Location: 560 Fairway Dr, Pocatello, ID, 83201-5046
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Provider Profile Details
NPI Number
1639779523
Provider Name
Tracie Lyn Hansen
Credential
BS
Provider Entity Type
Individual
Gender
Female
Address
560 Fairway Dr, Pocatello, ID, 83201-5046
Phone Number
208-242-6669
Fax Number
Provider Enumeration Date
10/29/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
560 Fairway Dr
City
State
Zip
83201-2012
Phone Number
208-242-6669
Fax Number
person
Provider Business Mailing Address Details
Address
560 Fairway Dr
City
State
Zip
83201-2012
Phone Number
208-242-6669
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
License No.
CPSS055 (Idaho)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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