Individual
MRS. NOVELLA G. HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADAC
Contact information
Practice address
1190 FOSTER RD, LAS CRUCES, NM 88001-3775
(575) 541-0986
(575) 541-8377
Mailing address
PO BOX 4068, LAS CRUCES, NM 88003-4068
(575) 541-0986
(575) 541-8377
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T-0135191
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
T-0135191
SUBSTANCE ABUSE
NM
Enumeration date
11/09/2010
Last updated
11/09/2010
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