Provider Demographics
NPI:1790384485
Name:HERNANDEZ SANCHEZ, NADADJA
Entity Type:Individual
Prefix:
First Name:NADADJA
Middle Name:
Last Name:HERNANDEZ SANCHEZ
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 1:550 TOXAWAY DR
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33413-1158
Mailing Address - Country:US
Mailing Address - Phone:561-707-0370
Mailing Address - Fax:
Practice Address - Street 1:550 TOXAWAY DR
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33413-1158
Practice Address - Country:US
Practice Address - Phone:561-707-0370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-22
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-23-14314106E00000X
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst