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Individual
ODALYS HERNANDEZ
Active
Individual
ODALYS HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCM
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-18-74552
FL
171M00000X
Case Manager/Care Coordinator
CCM100323
FL
363A00000X
Physician Assistant
2781
PR
Other
Enumeration date
11/01/2017
Last updated
10/04/2025
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