Individual
ISVI HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
10915 W 133RD AVE, CEDAR LAKE, IN 46303-9706
(219) 390-7498
(219) 390-7549
Mailing address
10915 W 133RD AVE, CEDAR LAKE, IN 46303-9706
(219) 390-7498
(219) 390-7549
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32002166A
IN
Other
Enumeration date
08/11/2015
Last updated
08/11/2015
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