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General NPI Number Information
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NPI Number | 1841794245
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Entity Type | Individual
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Provider Name | DAISY HERNANDEZ
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Gender | Female
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Dates
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Enumeration Date | 03/20/2018
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Last Update Date | 03/20/2018
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Provider Practice Location Address
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Address Line | 3875 POST RD
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City | CUMMING
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State | GA
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Zip | 30040-5354
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Country | US
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Telephone | 770-886-2630
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Fax |
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Provider Business Mailing Address
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Address Line | 470 TUMBLING CREEK DR
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City | ALPHARETTA
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State | GA
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Zip | 30005-6476
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number |
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License Number State |
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