Individual
KELLY HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. EX.ED.
Contact information
Practice address
40 QUAKER LAKE TER, ORCHARD PARK, NY 14127-2826
(716) 662-2166
Mailing address
40 QUAKER LAKE TER, ORCHARD PARK, NY 14127-2826
(716) 662-2166
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
910969991
NY
Other
Enumeration date
08/28/2008
Last updated
08/28/2008
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