Provider Demographics
NPI:1184665879
Name:HERNANDEZ, LAURA LUISA (MS, PHL)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:LUISA
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:MS, PHL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:E18 CALLE YAGUEZ
Mailing Address - Street 2:URB. VILLA BORINQUEN
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-8004
Mailing Address - Country:US
Mailing Address - Phone:787-579-2562
Mailing Address - Fax:
Practice Address - Street 1:E18 CALLE YAGUEZ
Practice Address - Street 2:URB. VILLA BORINQUEN
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-8004
Practice Address - Country:US
Practice Address - Phone:787-579-2562
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR765235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist