Individual
NINOTCHKA ROMAN HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
1250 N 113TH ST STE 200, WAUWATOSA, WI 53226-3209
(262) 432-6600
Mailing address
1250 N 113TH ST STE 200, WAUWATOSA, WI 53226-3209
(262) 432-6600
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
295538
KY
103TC0700X
Clinical Psychologist
Primary
5582-57
WI
103TC0700X
Clinical Psychologist
LP-03375-T
KS
Other
Enumeration date
09/25/2024
Last updated
07/21/2026
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