Healthcare Provider Details

I. General information

NPI: 1356286694
Provider Name (Legal Business Name): KLENSLY HERNANDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 E CHICAGO ST
COLDWATER MI
49036-2074
US

IV. Provider business mailing address

325 N MATTESON ST
BRONSON MI
49028-1125
US

V. Phone/Fax

Practice location:
  • Phone: 517-774-9911
  • Fax:
Mailing address:
  • Phone: 269-503-6780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: