Healthcare Provider Details

I. General information

NPI: 1073229134
Provider Name (Legal Business Name): TAYLOR DOLORES FLETCHER HERNANDEZ BSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2023
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

621 N MCKINLEY ST
HOBBS NM
88240-8256
US

IV. Provider business mailing address

1700 W VAN BUREN AVE
LOVINGTON NM
88260-3029
US

V. Phone/Fax

Practice location:
  • Phone: 575-393-0755
  • Fax:
Mailing address:
  • Phone: 575-607-7191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSWB-2022-0799
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number0799
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: