Individual
SHEYENNE DAWN HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1248 E 17TH ST, IDAHO FALLS, ID 83404-6126
(208) 542-1026
Mailing address
69 N 900 W, BLACKFOOT, ID 83221-5390
(208) 681-3013
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LMSW45186
ID
1041S0200X
School Social Worker
LSW-31953
ID
Other
Enumeration date
07/17/2025
Last updated
07/17/2025
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