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Individual

BILLY HERNAIZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2222 COLONIAL RD STE 100, FORT PIERCE, FL 34950-5309
(772) 489-4726
(772) 489-0423
Mailing address
5874 NW DOWSE ST, PORT ST LUCIE, FL 34986-3922
(917) 837-7989

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
106H00000X
FL
Enumeration date
12/11/2015
Last updated
11/02/2021
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