Individual
JESARELI HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
816 HOLLAND SQ, WYOMISSING, PA 19610-3007
(830) 968-5658
Mailing address
816 HOLLAND SQ, WYOMISSING, PA 19610-3007
(830) 968-5658
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
103754
TX
235Z00000X
Speech-Language Pathologist
Primary
SL010505
PA
Other
Enumeration date
01/25/2010
Last updated
08/30/2011
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