Individual
MRS. TAMARA ANN HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPC-I, MSCRMHC, BS
Contact information
Practice address
1040 JUNIPER RIDGE AVE, HENDERSON, NV 89015-6902
(702) 809-7748
Mailing address
3960 E PATRICK LN STE 202, LAS VEGAS, NV 89120-4902
(702) 810-9927
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1922581396
REGISTERED BEHAVIOR TECHNICIAN
MI
05
—
1922581396
—
MI
Enumeration date
09/12/2018
Last updated
02/28/2024
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