Individual
KELLY VANESSA HERNANDEZ JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4709 CHERRY HILL RD, COLLEGE PARK, MD 20740-1329
(240) 701-1132
Mailing address
4709 CHERRY HILL RD, COLLEGE PARK, MD 20740-1329
(240) 701-1132
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
ACTIVE
MD
Other
Enumeration date
06/19/2020
Last updated
06/19/2020
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