Provider Demographics
NPI:1265738868
Name:HERNANDEZ, ALISON (PSYCHOLOGIST)
Entity type:Individual
Prefix:DR
First Name:ALISON
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 CHESAPEAKE RIDGE LN APT 3A
Mailing Address - Street 2:
Mailing Address - City:NORTH EAST
Mailing Address - State:MD
Mailing Address - Zip Code:21901-2430
Mailing Address - Country:US
Mailing Address - Phone:954-309-2300
Mailing Address - Fax:
Practice Address - Street 1:206 MECHANICS VALLEY RD
Practice Address - Street 2:
Practice Address - City:NORTH EAST
Practice Address - State:MD
Practice Address - Zip Code:21901-3824
Practice Address - Country:US
Practice Address - Phone:410-569-9497
Practice Address - Fax:410-569-0094
Is Sole Proprietor?:No
Enumeration Date:2011-01-31
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04936103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist