Most Relevant Information
Provider Data
| NPI Number: | 1003057928 |
| Provider Name: | NICOLE HERNANDEZ OTR/L |
| Entity Type: | Individual |
| Taxonomy Code: | 225X00000X |
| Specialty: | Occupational Therapist |
| License Number: | 4332 |
Most Important Dates
| Enumeration Date: | 03/23/2009 |
| Last Updated: | 11/13/2023 |
Provider Practice Location
13481 W MCDOWELL RD STE 300
GOODYEAR
AZ
853952724
Practice Location Phone/Fax
| Phone: | 4802443651 |
| Fax: |
Provider Mailing Location
14442 W CHAMA DR
SURPRISE
AZ
853877028
Provider Mailing Phone/Fax
| Phone: | 4802443651 |
| Fax: |