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General NPI Number Information
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NPI Number | 1689565665
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Entity Type | Individual
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Provider Name | HOLLY FERNANDEZ
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Gender |
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Dates
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Enumeration Date | 07/09/2025
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Last Update Date | 07/09/2025
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Provider Practice Location Address
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Address Line | 1922 DRY CREEK WAY STE 101
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City | SAN ANTONIO
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State | TX
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Zip | 78259-1840
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Country | US
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Telephone | 910-916-4874
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Fax |
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Provider Business Mailing Address
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Address Line | 3919 PERRIN CENTRAL BLVD APT 616
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City | SAN ANTONIO
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State | TX
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Zip | 78217-2726
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Country | US
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Telephone | 910-916-4874
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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