Individual
SAMANTHA HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6405 GATO RD, ANTHONY, NM 88021-9299
(575) 520-1931
Mailing address
6405 GATO RD, ANTHONY, NM 88021-9299
(575) 520-1931
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
97358
TX
101YM0800X
Mental Health Counselor
Primary
CCMH0224861
NM
Other
Enumeration date
01/09/2019
Last updated
01/30/2025
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