Individual
CHRISTINA HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSAA, CHW
Contact information
Practice address
1609 CAMINO RANCHEROS, GALLUP, NM 87301-6857
(505) 870-1236
Mailing address
2111 COLLEGE DR, GALLUP, NM 87301-5600
(505) 397-5172
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CTB-2024-0172
NM
172V00000X
Community Health Worker
S1-1635
NM
Other
Enumeration date
08/26/2024
Last updated
03/06/2025
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