| NPI | 1851816193 |
|---|---|
| Former Name | NICOLE AYSSA HERNANDEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 13006) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC A13006) |
| Enumeration Date | 2017-08-08 |
| Last Update Date | 2023-12-10 |