Individual
MR. JOSE ALFREDO HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW, QSUDP
Contact information
Practice address
704 ALBANY ST, CALDWELL, ID 83605-3501
(208) 454-5133
(208) 454-0749
Mailing address
704 ALBANY ST, CALDWELL, ID 83605-3501
(208) 454-5133
(208) 454-0749
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-33530
ID
Other
Enumeration date
02/19/2014
Last updated
02/19/2014
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