Individual
MARA HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.C.
Contact information
Practice address
1105 WHITAKER LN, EL PASO, TX 79902-2126
(915) 533-1929
(877) 587-9452
Mailing address
1105 WHITAKER LN, EL PASO, TX 79902-2126
(915) 533-1929
(877) 587-9452
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
15728
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
028876302
—
TX
01
—
7042LC
BXBS
TX
Enumeration date
09/26/2006
Last updated
03/14/2012
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