Individual
CRYSTAL EDITH HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2711 NW 12TH ST, OKLAHOMA CITY, OK 73107-5421
(405) 589-2017
Mailing address
2711 NW 12TH ST, OKLAHOMA CITY, OK 73107-5421
(405) 589-2017
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/26/2021
Last updated
03/24/2021
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