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General NPI Number Information
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NPI Number | 1801240452
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Entity Type | Individual
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Provider Name | MONICA HERNANDEZ
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Gender | Female
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Dates
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Enumeration Date | 04/20/2016
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Last Update Date | 04/20/2016
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Provider Practice Location Address
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Address Line | 510 E LISA DR
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City | CHAPARRAL
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State | NM
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Zip | 88081-7809
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Country | US
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Telephone | 575-824-0820
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Fax | 575-824-1021
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Provider Business Mailing Address
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Address Line | 385 CALLE DE ALEGRA BLDG. A
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City | LAS CRUCES
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State | NM
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Zip | 88005-3423
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Country | US
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Telephone | 575-526-1105
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Fax | 575-524-4266
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | M-09504
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License Number State | NM
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