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1336501691
TIMOTHY HERNANDEZ
FAIRHAVEN, MA
NPI
1336501691
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MA 11680)
Enumeration Date
2016-03-25
Last Update Date
2016-03-25
Business Address
-- TIMOTHY HERNANDEZ LADC I
295 SCONTICUT NECK RD
FAIRHAVEN, MA 02719-1506
Phone number: 508-863-6733
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Mailing Address
-- TIMOTHY HERNANDEZ LADC I
295 SCONTICUT NECK RD
FAIRHAVEN, MA 02719-1506
Phone number: 508-863-6733
Copy
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