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Individual

JACQUELINE ELIZA HERNANDEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MHC-LP

Contact information

Practice address
19 UNION SQ W FL 7, NEW YORK, NY 10003-3304
(212) 627-9600
Mailing address
1662 CORNELIA ST, RIDGEWOOD, NY 11385-4723
(646) 250-1160

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
100455-01
NY

Other

Enumeration date
12/18/2020
Last updated
12/18/2020
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