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NPI Code Detail

MEDICARE: MS. JUNE LEE HERNANDEZ

MEDICARE:  MS. JUNE LEE  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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1588952816
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JUNE LEE HERNANDEZ
Provider Business Mailing Address
First Line : 1941 E 5625 S
Second Line :
City : SOUTH OGDEN
State : UT
Zip : 84403-4949
Country : US
Telephone Number : 801-644-9416
Fax Number :
Provider Business Practice Location Address
First Line : 2550 WASHINGTON BLVD STE 200
Second Line :
City : OGDEN
State : UT
Zip : 84401-3121
Country : US
Telephone Number : 801-621-8670
Fax Number : 801-621-4512
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2011
Last Update Date : 04/15/2015

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Directions to “ MS. JUNE LEE HERNANDEZ ” Practice Location

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