Healthcare Provider Details

I. General information

NPI: 1134208564
Provider Name (Legal Business Name): JOY LYNN HOOFER PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/05/2006
Last Update Date: 10/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 W 6TH ST STE 160
NEWTON KS
67114-2166
US

IV. Provider business mailing address

2926 TILBURY LN
HALSTEAD KS
67056
US

V. Phone/Fax

Practice location:
  • Phone: 316-212-6287
  • Fax: 316-283-1142
Mailing address:
  • Phone: 316-212-6287
  • Fax: 316-283-1142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1658
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: