Individual
VICKI R HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7360 KATRIN DR, WEST BLOOMFIELD, MI 48322-3559
(248) 539-7665
Mailing address
7360 KATRIN DR, WEST BLOOMFIELD, MI 48322-3559
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7501004214
MI
Other
Enumeration date
05/25/2017
Last updated
05/25/2017
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