Individual
JULYSSA AIDEE HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLPA
Contact information
Practice address
2424 E SOUTHERN AVE, MESA, AZ 85204-5409
(480) 361-1972
Mailing address
6152 W OAKLAND ST APT 201, CHANDLER, AZ 85226-2613
(928) 919-2819
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SLPA12996
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SLPA12996
LICENSE
AZ
Enumeration date
04/28/2021
Last updated
09/07/2022
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