Individual
KELSEY HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
237 26TH ST, OGDEN, UT 84401-3105
(801) 625-3700
Mailing address
237 26TH ST, OGDEN, UT 84401-3105
(801) 625-3700
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
8909358-3502
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
260022408
RAILROAD MEDICARE
UT
05
—
876000308007
—
UT
Enumeration date
05/28/2014
Last updated
11/15/2016
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