Provider Demographics
NPI:1033094479
Name:HANSEN, DANETTE JAN (MSW)
Entity type:Individual
Prefix:
First Name:DANETTE
Middle Name:JAN
Last Name:HANSEN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:186 E 1800 N
Mailing Address - Street 2:
Mailing Address - City:NORTH LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84341-2019
Mailing Address - Country:US
Mailing Address - Phone:435-213-3062
Mailing Address - Fax:435-752-1095
Practice Address - Street 1:186 E 1800 N
Practice Address - Street 2:
Practice Address - City:NORTH LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84341-2019
Practice Address - Country:US
Practice Address - Phone:435-213-3062
Practice Address - Fax:435-752-1095
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-06
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker