Hernandez Hacker, Priscilla D.

Hernandez Hacker, Priscilla D. is an sole proprietor health care provider with primary practice located at 828 S Washington St Ste A , Moscow ID 83843-3055. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Hernandez Hacker, Priscilla D. can be contacted via phone (208) 883-7766.

Contact Information

Primary practice address
828 S Washington St Ste A Moscow ID 83843-3055
Fax: (208) 883-8062
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PY1696 Washington
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY202196 Idaho

Profile Details

NPI number 1063469203
LBN Legal business name Hernandez Hacker, Priscilla D.
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 30th, 2006
Last updated May 20th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063469203 NPPES
Idaho Other 000010149290 REGENCE BLUE SHIELD PIN
Idaho Other 380-319 REGENCE BLUE SHIELD PIN

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