Provider Demographics
NPI:1699243535
Name:HERNDON, ERANDI AGUILAR (MFT)
Entity type:Individual
Prefix:
First Name:ERANDI
Middle Name:AGUILAR
Last Name:HERNDON
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2706 WILLIAMSBURG CT
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80521-4025
Mailing Address - Country:US
Mailing Address - Phone:402-708-9767
Mailing Address - Fax:
Practice Address - Street 1:2706 WILLIAMSBURG CT
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80521-4025
Practice Address - Country:US
Practice Address - Phone:402-708-9767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-08
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMFTC.0013714106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist