Individual
NICOLE HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
13481 W MCDOWELL RD STE 300, GOODYEAR, AZ 85395-2724
(480) 244-3651
Mailing address
14442 W CHAMA DR, SURPRISE, AZ 85387-7028
(480) 244-3651
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
4332
AZ
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
4332
AZ
225XP0200X
Pediatric Occupational Therapist
4332
AZ
Other
Enumeration date
03/23/2009
Last updated
11/13/2023
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