Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | MH18570 | FL |
NPI | 1003213703 |
---|---|
Provider Name | Maria O Hernandez |
First Address | Miami, FL 33170-7602 |
Second Address | Miami, FL 33170-7602 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/11/2014 |
Last Update Date | 02/12/2020 |