Individual
NICOLE HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSW
Contact information
Practice address
1819 N 34TH AVE, STONE PARK, IL 60165-1023
(773) 574-0716
Mailing address
1819 N 34TH AVE, STONE PARK, IL 60165-1023
(773) 574-0716
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
H65562089951
IL
Other
Enumeration date
01/10/2017
Last updated
01/10/2017
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