MEDICARE: PIERRE 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
1	1041C0700X	Clinical Social Worker	CSW006803	GA

General Provider Information

NPI Number	:	1629480157
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PIERRE HOOTEN

Provider Business Mailing Address
First Line	:	500 NORTHSIDE CIR NW APT V3
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30309-2111
Country	:	US
Telephone Number	:	678-607-7203
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 NORTHSIDE CIR NW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30309-2122
Country	:	US
Telephone Number	:	678-607-7203
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2014
Last Update Date	:	05/24/2019

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Directions to “ PIERRE HOOTEN ” Practice Location

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