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Individual

ANDREA MARIA HERNANDEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CTRS/L

Contact information

Practice address
2615 E CLINTON AVE, FRESNO, CA 93703-2223
(559) 225-6100
Mailing address
2615 E CLINTON AVE, FRESNO, CA 93703-2223
(559) 225-6100

Taxonomy

Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
168
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
168
OKLAHOMA STATE BOARD OF MEDICAL LICENSURE AND SUPERVISION
OK
01
61269
NCTRC
Enumeration date
07/29/2019
Last updated
07/29/2019
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