Provider Demographics
NPI:1487462271
Name:HERNANDEZ, MARIA BORINQUEN
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:BORINQUEN
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COND MONTEBELLO APT N228
Mailing Address - Street 2:
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976-2419
Mailing Address - Country:US
Mailing Address - Phone:787-422-0233
Mailing Address - Fax:
Practice Address - Street 1:COND MONTEBELLO APT N228
Practice Address - Street 2:
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976-2419
Practice Address - Country:US
Practice Address - Phone:787-422-0233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-25
Last Update Date:2024-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR146481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical