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NPI Code Detail

MEDICARE: SELENA HERNANDEZ LMSW

MEDICARE: SELENA HERNANDEZ LMSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial WorkerAZ

General Provider Information

NPI Number : 1508674326
Entity Type Code : Individual
Provider Name (Legal Business Name) : SELENA HERNANDEZ LMSW
Provider Business Mailing Address
First Line : 32285 N SADDLEHORN DR
Second Line :
City : SAN TAN VALLEY
State : AZ
Zip : 85140-0155
Country : US
Telephone Number : 480-628-7647
Fax Number :
Provider Business Practice Location Address
First Line : 3512 N HIGLEY RD
Second Line :
City : MESA
State : AZ
Zip : 85215-9713
Country : US
Telephone Number : 602-449-7999
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/26/2024
Last Update Date : 12/26/2024

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Directions to “ SELENA HERNANDEZ LMSW” Practice Location

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