Individual
ELSA R HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
6655 S YALE AVE, LAUREATE PSYCHIATRIC CLINIC AND HOSPITAL, TULSA, OK 74136-3326
(918) 491-3704
(918) 491-5740
Mailing address
PO BOX 21228, DEPARTMENT 31, TULSA, OK 74121-1228
(918) 491-3704
(918) 491-5740
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
959
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2252488
CIGNA BEH HEALTH
—
01
—
7234755
AETNA
—
Enumeration date
12/27/2006
Last updated
01/31/2017
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