| Doctor Name: | JESSICA RUSSELL HERNANDEZ |
| NPI Number: | 1023279981 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 44SC05240800 |
| Business Practice Address: | 1930 Marlton Pike E Building Q Cherry Hill, NJ - 080032150 |
| Business Phone Number: | 8569943343 |
| Business Fax Number: | 8564347112 |
| Mailing Address: | 1930 Marlton Pike E, Building Q CHERRY HILL |
| State: | NJ |
| Postal Code: | 080032150 |
| Phone Number: | 8569943343 |
| Fax Number: | 8564347112 |
| NPI Enumeration Date: | 06/23/2008 |
| NPI Last Update Date: | 10/08/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 44SC05240800 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |