Doctor Name: | ERICA HERNANDEZ |
NPI Number: | 1104215458 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 2014021031 |
Business Practice Address: | 2201 Glenn Hendren Dr Liberty, MO - 640683375 |
Business Phone Number: | 8167922211 |
Business Fax Number: | |
Mailing Address: | 2201 Glenn Hendren Dr, LIBERTY |
State: | MO |
Postal Code: | 640683375 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 01/09/2015 |
NPI Last Update Date: | 01/09/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 2014021031 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |