Individual
LORRAINE HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1905 S TOPAZ WAY, MERIDIAN, ID 83642-4477
(208) 417-7971
Mailing address
961 W APPLE PINE ST, MERIDIAN, ID 83646-6058
(208) 613-4990
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/24/2024
Last updated
07/24/2024
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