Individual
DESTRY HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1100 W 21ST ST, CLOVIS, NM 88101-4151
(575) 769-2345
Mailing address
1100 W 21ST ST, CLOVIS, NM 88101-4151
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/19/2013
Last updated
03/17/2018
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