Provider Demographics
NPI:1073211470
Name:HERNANDEZ, RAQUEL ENID
Entity Type:Individual
Prefix:
First Name:RAQUEL
Middle Name:ENID
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RAQUEL
Other - Middle Name:E
Other - Last Name:HERNANDEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:APARTADO POSTAL 366528
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-6528
Mailing Address - Country:US
Mailing Address - Phone:787-754-8500
Mailing Address - Fax:787-999-0838
Practice Address - Street 1:APARTADO POSTAL 366528
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00936-6528
Practice Address - Country:US
Practice Address - Phone:787-754-8500
Practice Address - Fax:787-999-0838
Is Sole Proprietor?:No
Enumeration Date:2023-02-16
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR78541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical