MEDICARE: MS. ARIEL DANIELLE HERNANDEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	95669	TX

General Provider Information

NPI Number	:	1396510145
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ARIEL DANIELLE HERNANDEZ

Provider Business Mailing Address
First Line	:	9050 SUMMIT OXBOW RD APT 11211
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76123-2494
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9050 SUMMIT OXBOW RD
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76123-2493
Country	:	US
Telephone Number	:	314-943-8170
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/21/2023
Last Update Date	:	08/28/2024

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