Individual
KAYLIE CAMILLE HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
519 LATHAM DR, LOWELL, AR 72745-8360
(479) 750-0130
Mailing address
519 LATHAM DR, LOWELL, AR 72745-8360
(479) 750-0130
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
06/25/2018
Last updated
06/25/2018
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