Most Relevant Information
Provider Data
| NPI Number: | 1003481763 |
| Provider Name: | MIRANDA ARISBET HERNANDEZ |
| Entity Type: | Individual |
| Taxonomy Code: | 104100000X |
| Specialty: | Social Worker |
| License Number: | LMSW-40800 |
Most Important Dates
| Enumeration Date: | 05/25/2021 |
| Last Updated: | 05/25/2021 |
Provider Practice Location
250 S MAIN ST
PAYETTE
ID
836612853
Practice Location Phone/Fax
| Phone: | 2084064245 |
| Fax: |
Provider Mailing Location
250 S MAIN ST
PAYETTE
ID
836612853
Provider Mailing Phone/Fax
| Phone: | 2084064245 |
| Fax: |