| NPI | 1861369043 |
|---|---|
| Professional Name | EDNA IVETH FERNANDEZ |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: KY 850095) |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: KY 850095) |
| Enumeration Date | 2025-10-21 |
| Last Update Date | 2025-10-21 |