Provider Demographics
NPI:1548659881
Name:HANNA, VALERIE JEAN (LAC DIPLO OF ACU,)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:JEAN
Last Name:HANNA
Suffix:
Gender:F
Credentials:LAC DIPLO OF ACU,
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:JEAN
Other - Last Name:STERNBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:465 SHADY RIDGE RD NW
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:MN
Mailing Address - Zip Code:55350-1431
Mailing Address - Country:US
Mailing Address - Phone:320-583-0105
Mailing Address - Fax:
Practice Address - Street 1:35 MAIN ST N
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:MN
Practice Address - Zip Code:55350-1805
Practice Address - Country:US
Practice Address - Phone:320-583-0105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-09
Last Update Date:2015-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1032171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist