Individual
MAGGIE S HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
YCS
Contact information
Practice address
1111 W FIR ST, PORTALES, NM 88130-5826
(575) 356-5112
Mailing address
PO BOX 28220, SANTA FE, NM 87592-8220
(505) 471-5006
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/08/2010
Last updated
07/08/2010
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