Provider Demographics
NPI:1114670817
Name:HERNANDEZ, FELICIA JANE
Entity Type:Individual
Prefix:MS
First Name:FELICIA
Middle Name:JANE
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 GLENROSE RD
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02124-2605
Mailing Address - Country:US
Mailing Address - Phone:857-246-2820
Mailing Address - Fax:
Practice Address - Street 1:9 GLENROSE RD
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02124-2605
Practice Address - Country:US
Practice Address - Phone:857-246-2820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-02
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker