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NPI Code Detail

MEDICARE: ALYSSA MARIAH HERNANDEZ

MEDICARE: ALYSSA MARIAH HERNANDEZ
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
1106S00000XBehavior Technician
2103K00000XBehavior Analyst1-22-62338TX

General Provider Information

NPI Number : 1992279285
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSSA MARIAH HERNANDEZ
Provider Business Mailing Address
First Line : 6222 W IH 10 STE 104
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78201-2013
Country : US
Telephone Number : 210-447-0028
Fax Number :
Provider Business Practice Location Address
First Line : 133 WINDY MEADOWS DR
Second Line :
City : SCHERTZ
State : TX
Zip : 78154-1539
Country : US
Telephone Number : 210-321-9275
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2019
Last Update Date : 03/31/2023

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Directions to “ ALYSSA MARIAH HERNANDEZ ” Practice Location

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