Individual
SARAH HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-36400
Contact information
Practice address
1908 JENNIE LEE DR, IDAHO FALLS, ID 83404-6159
(208) 932-7048
(208) 970-6188
Mailing address
1908 JENNIE LEE DR, IDAHO FALLS, ID 83404-6159
(208) 932-7048
(208) 970-6188
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
LMSW-33381
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1184022493
—
ID
Enumeration date
12/18/2014
Last updated
08/29/2023
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