Healthcare Provider Details

I. General information

NPI: 1427720671
Provider Name (Legal Business Name): HALEE CHEYENNE HERNANDEZ M.A., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2021
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4950 MCNUTT RD
SUNLAND PARK NM
88008-9621
US

IV. Provider business mailing address

4950 MCNUTT RD
SUNLAND PARK NM
88008-9621
US

V. Phone/Fax

Practice location:
  • Phone: 575-882-6200
  • Fax:
Mailing address:
  • Phone: 575-882-6200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSAH-2025-0383
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: