Healthcare Provider Details

I. General information

NPI: 1225428014
Provider Name (Legal Business Name): JENNIFER HOOKS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2015
Last Update Date: 01/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2238 1ST ST
SLIDELL LA
70458-3606
US

IV. Provider business mailing address

2238 1ST ST
SLIDELL LA
70458-3606
US

V. Phone/Fax

Practice location:
  • Phone: 985-690-6622
  • Fax: 985-690-6662
Mailing address:
  • Phone: 985-690-6622
  • Fax: 985-690-6662

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number10650
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: