Healthcare Provider Details

I. General information

NPI: 1346653524
Provider Name (Legal Business Name): ANA L HERNANDEZ ARIAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2014
Last Update Date: 04/17/2023
Certification Date: 04/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 PLEASANT ST ROOM 100
FALL RIVER MA
02721-3015
US

IV. Provider business mailing address

5526 CHASE FLS
SAN ANTONIO TX
78266-4432
US

V. Phone/Fax

Practice location:
  • Phone: 774-294-5722
  • Fax: 774-294-5724
Mailing address:
  • Phone: 469-530-8424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number79217
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number79217
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: