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NPI Code Detail

MEDICARE: KIRSTIE HOOTEN

MEDICARE: KIRSTIE HOOTEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior AnalystTX

General Provider Information

NPI Number : 1366848244
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIRSTIE HOOTEN
Provider Business Mailing Address
First Line : 5633 SANTA ELENA CT
Second Line :
City : FORT WORTH
State : TX
Zip : 76126-4995
Country : US
Telephone Number : 618-231-2373
Fax Number :
Provider Business Practice Location Address
First Line : 8260 PRECINCT LINE RD
Second Line :
City : NORTH RICHLAND HILLS
State : TX
Zip : 76182-8608
Country : US
Telephone Number : 618-231-2373
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/05/2014
Last Update Date : 06/20/2022

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