Healthcare Provider Details

I. General information

NPI: 1033029343
Provider Name (Legal Business Name): GINA LEE HOOPER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

889 SEVEN OAKS BLVD STE 1110
SMYRNA TN
37167-6688
US

IV. Provider business mailing address

12041 W TRIMBLE RD
MILTON TN
37118-4302
US

V. Phone/Fax

Practice location:
  • Phone: 615-625-2852
  • Fax:
Mailing address:
  • Phone: 615-278-0741
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2639
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: