Most Relevant Information
Provider Data
| NPI Number: | 1003599762 |
| Provider Name: | JENNIFER R HERNANDEZ CRM |
| Entity Type: | Individual |
| Taxonomy Code: | 175T00000X |
| Specialty: | Peer Specialist |
| License Number: | 22-CRM-1469 |
Most Important Dates
| Enumeration Date: | 08/09/2023 |
| Last Updated: | 08/09/2023 |
Provider Practice Location
2301 COVE AVE
LA GRANDE
OR
978503906
Practice Location Phone/Fax
| Phone: | 5419628800 |
| Fax: | 5419635272 |
Provider Mailing Location
2301 COVE AVE
LA GRANDE
OR
978503906
Provider Mailing Phone/Fax
| Phone: | 5419628800 |
| Fax: | 5419635272 |