Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003116468 |
---|---|
Provider Name | Andrea Gayle Hernandez |
First Address | Sparks, NV 89431-1949 |
Second Address | Reno, NV 89509-4734 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2010 |
Last Update Date | 01/11/2010 |