Provider Demographics
NPI:1467200717
Name:HERNANDEZ-HIERRO, LUXAIDA J
Entity type:Individual
Prefix:
First Name:LUXAIDA
Middle Name:J
Last Name:HERNANDEZ-HIERRO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 NEWPORT DR
Mailing Address - Street 2:
Mailing Address - City:HAZLETON
Mailing Address - State:PA
Mailing Address - Zip Code:18201-7669
Mailing Address - Country:US
Mailing Address - Phone:570-359-7808
Mailing Address - Fax:
Practice Address - Street 1:1500 KINGS HWY N
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-2304
Practice Address - Country:US
Practice Address - Phone:215-821-8819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-10
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health