Tracie Lyn Hansen, BS - Pocatello, ID

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.

Location: 560 Fairway Dr, Pocatello, ID, 83201-5046

NPI Number

1639779523

Provider Name

Tracie Lyn Hansen

Credential

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

Address

560 Fairway Dr

City

Pocatello

State

Idaho

Zip

83201-2012

Phone Number

208-242-6669

Fax Number

Address

560 Fairway Dr

City

Pocatello

State

Idaho

Zip

83201-2012

Phone Number

208-242-6669

Fax Number

Type

Other Service Providers

Classification

Peer Specialist

Speciality

Taxonomy

175T00000X

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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