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Individual

JAYDEN HERNANDEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LSAA

Contact information

Practice address
2301 7TH ST STE A, LAS VEGAS, NM 87701-4966
(505) 454-9611
Mailing address
105 PASEO DEL CANON W STE A, TAOS, NM 87571-6943
(575) 737-5533

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
104100000X
Social Worker

Other

Enumeration date
07/11/2024
Last updated
10/23/2024
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