SHEYENNE DAWN HERNANDEZ
Individual Provider (NPI-1)
Active
Social Worker, Clinical
Provider Information
- NPI Number
1194617845- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 1248 E 17TH ST, IDAHO FALLS, ID, 834046126
- Phone
- (208) 542-1026
Specialties & Taxonomies
Social Worker, School
License: ID #LSW-31953
Social Worker, Clinical
Primary License: ID #LMSW45186