Doctor Name: | KIJUANA HOOPER |
NPI Number: | 1104212273 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 8644 S 86th Ave Building 10 Apt. 113 Justice, IL - 604582111 |
Business Phone Number: | 7085460806 |
Business Fax Number: | 7085460888 |
Mailing Address: | 8644 S 86th Ave, Building 10 Apt. 113 JUSTICE |
State: | IL |
Postal Code: | 604582111 |
Phone Number: | 7085460806 |
Fax Number: | 7085460888 |
NPI Enumeration Date: | 04/15/2015 |
NPI Last Update Date: | 04/15/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |