Individual
ANNA MARIE HERNANDEZ-RAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1545 S 1100 E STE 4, SALT LAKE CITY, UT 84105-2476
(801) 386-0278
Mailing address
1010 E EMERSON AVE, SALT LAKE CITY, UT 84105-2416
(801) 386-0278
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
12621793-1103
UT
374700000X
Technician
12621793-1103
UT
Other
Enumeration date
08/14/2023
Last updated
08/22/2023
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