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General NPI Number Information
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NPI Number | 1063949279
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Entity Type | Individual
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Provider Name | PAULA MARIE HERNANDEZ MSW
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Gender | Female
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Dates
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Enumeration Date | 05/18/2017
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Last Update Date | 09/23/2024
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Provider Practice Location Address
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Address Line | 9315 TELEGRAPH RD
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City | REDFORD
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State | MI
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Zip | 48239-1260
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Country | US
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Telephone | 313-450-4500
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Fax | 313-450-0004
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Provider Business Mailing Address
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Address Line | 15591 WARWICK AVE
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City | ALLEN PARK
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State | MI
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Zip | 48101-2727
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Country | US
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Telephone | 313-550-8118
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801097188
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6852093509
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License Number State | MI
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