Provider Demographics
NPI:1275742744
Name:HERNANDEZ, SANDRA ANTONIA (BA)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:ANTONIA
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:BA
Other - Prefix:MRS
Other - First Name:SANDRA
Other - Middle Name:ANTONIA
Other - Last Name:HERNANDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:PO BOX 1629
Mailing Address - Street 2:
Mailing Address - City:HATILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00659-8629
Mailing Address - Country:US
Mailing Address - Phone:787-898-8836
Mailing Address - Fax:
Practice Address - Street 1:CALLE FRANCISCO VELAZQUEZ # 119
Practice Address - Street 2:
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00659
Practice Address - Country:US
Practice Address - Phone:787-898-0064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0004142355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant