Individual
JACQUELINE RENEE HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1 PARKLANE BLVD STE 200E, DEARBORN, MI 48126-2400
(313) 846-2606
Mailing address
27085 GRATIOT AVE, ROSEVILLE, MI 48066-2984
(586) 204-5560
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201002513
MI
Other
Enumeration date
07/12/2022
Last updated
07/12/2022
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