Provider Demographics
NPI:1790479608
Name:HERNANDEZ, CHEYENNE JEAN-MARIE (SCHOOL PSYCHOLOGIST)
Entity Type:Individual
Prefix:MRS
First Name:CHEYENNE
Middle Name:JEAN-MARIE
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:SCHOOL PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 S OAKLAND ST
Mailing Address - Street 2:
Mailing Address - City:WEBB CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64870-2453
Mailing Address - Country:US
Mailing Address - Phone:417-380-4913
Mailing Address - Fax:
Practice Address - Street 1:730 S OAKLAND ST
Practice Address - Street 2:
Practice Address - City:WEBB CITY
Practice Address - State:MO
Practice Address - Zip Code:64870-2453
Practice Address - Country:US
Practice Address - Phone:417-380-4913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool