Provider Demographics
NPI:1730847708
Name:HANSEN, ERYN BETLEY (MS, BCBA)
Entity type:Individual
Prefix:MS
First Name:ERYN
Middle Name:BETLEY
Last Name:HANSEN
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1528 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-4339
Mailing Address - Country:US
Mailing Address - Phone:651-233-7603
Mailing Address - Fax:
Practice Address - Street 1:3501 ALDRICH AVE S
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408-4149
Practice Address - Country:US
Practice Address - Phone:612-430-2635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-07
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst