Hernandez Hacker, Priscilla D.
Hernandez Hacker, Priscilla D. is an sole proprietor health care provider with primary practice located at 828 S Washington St Ste A , Moscow ID 83843-3055. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Hernandez Hacker, Priscilla D. can be contacted via phone (208) 883-7766.Contact Information
Primary practice address
828 S Washington St Ste A
Moscow ID 83843-3055
Phone: (208) 883-7766
Fax: (208) 883-8062
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | PY1696 | Washington |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | PSY202196 | Idaho |
Profile Details
| NPI number | 1063469203 |
|---|---|
| LBN Legal business name | Hernandez Hacker, Priscilla D. |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 30th, 2006 |
| Last updated | May 20th, 2024 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063469203 | NPPES |
| Idaho | Other | 000010149290 | REGENCE BLUE SHIELD PIN |
| Idaho | Other | 380-319 | REGENCE BLUE SHIELD PIN |
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