Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 3563 | PR |
NPI | 1093046955 |
---|---|
Provider Name | Shaira Hernandez |
First Address | Juncos, PR 00777-3417 |
Second Address | Juncos, PR 00777-3263 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/01/2010 |
Last Update Date | 02/05/2017 |