Individual
MR. JOVAN HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2600 MARBLE AVE NE, ALBUQUERQUE, NM 87106-2058
(505) 272-2190
Mailing address
2600 MARBLE AVE NE, ALBUQUERQUE, NM 87106-2058
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
08/20/2009
Last updated
08/20/2009
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