Individual
AIDA HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CASAC-T
Contact information
Practice address
127 E 105TH ST, NEW YORK, NY 10029-4917
(212) 289-1004
Mailing address
444 E 187TH ST APT 4D, BRONX, NY 10458-6644
(347) 644-3147
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
34629
NY
Other
Enumeration date
05/20/2019
Last updated
05/20/2019
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