Provider Demographics
NPI:1881408326
Name:HERNANDEZ, NYDIA IVETTE (MCD CF-SLP)
Entity type:Individual
Prefix:
First Name:NYDIA
Middle Name:IVETTE
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:MCD CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 N NOBLE ST
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:AR
Mailing Address - Zip Code:71646-2726
Mailing Address - Country:US
Mailing Address - Phone:870-831-0449
Mailing Address - Fax:
Practice Address - Street 1:1100 CAMP RD
Practice Address - Street 2:
Practice Address - City:CROSSETT
Practice Address - State:AR
Practice Address - Zip Code:71635-3553
Practice Address - Country:US
Practice Address - Phone:870-364-6521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR202993235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist