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General NPI Number Information
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NPI Number | 1235742719
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Entity Type | Individual
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Provider Name | CHARLENEE CORDERO-HERNANDEZ
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Gender | Female
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Dates
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Enumeration Date | 08/25/2020
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Last Update Date | 08/27/2020
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Provider Practice Location Address
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Address Line | BO. MAGUEYES CARR. PR 123, KM 10.1,
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City | PONCE
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State | PR
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Zip | 00731
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Country | US
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Telephone | 787-598-0323
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 331462
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City | PONCE
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State | PR
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Zip | 00733-1462
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Country | US
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Telephone |
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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 | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number | 7140
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License Number State | PR
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