Individual
KIRA HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1529 SAM RITTENBERG BLVD, CHARLESTON, SC 29407-4194
(888) 547-2250
Mailing address
1510 JAMES AVE UNIT 1, CHARLESTON AFB, SC 29404-5245
(318) 220-6940
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/27/2018
Last updated
08/27/2018
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