Individual
CARLY HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20329 N 59TH AVE STE A2, GLENDALE, AZ 85308-6854
(480) 787-5387
(623) 201-8589
Mailing address
11335 W PRIMROSE DR, AVONDALE, AZ 85392-3414
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SLPA10445
AZ
Other
Enumeration date
11/25/2020
Last updated
11/25/2020
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