Hernandez, Mary Lou

Hernandez, Mary Lou is an individual health care provider with primary practice located at 901 E Willetta St 3Rd Floor, Phoenix AZ 85006-2727. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Hernandez, Mary Lou can be contacted via phone (602) 239-6900.

Contact Information

Primary practice address
901 E Willetta St 3Rd Floor Phoenix AZ 85006-2727
Phone: (602) 239-6900
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 0169 Arizona

Profile Details

NPI number 1083668388
LBN Legal business name Hernandez, Mary Lou
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date May 20th, 2006
Last updated Apr 7th, 2008 - about 18 years ago

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 1083668388 NPPES
Arizona MEDICAID 897134

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