Doctor Name: | HEATHER HERNANDEZ |
NPI Number: | 1083006340 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CADC |
License Number: | 1184 |
Business Practice Address: | 628 Jefferson Ave Paintsville, KY - 412401471 |
Business Phone Number: | 6067896966 |
Business Fax Number: | 6067897466 |
Mailing Address: | 628 Jefferson Ave, PAINTSVILLE |
State: | KY |
Postal Code: | 412401471 |
Phone Number: | 6067896966 |
Fax Number: | 6067897466 |
NPI Enumeration Date: | 02/24/2015 |
NPI Last Update Date: | 02/24/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 1184 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |