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General NPI Number Information
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NPI Number | 1396227443
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Entity Type | Individual
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Provider Name | NICOLE HOOTEN
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Gender | Female
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Dates
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Enumeration Date | 09/05/2018
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 16151 WEBER RD
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City | CREST HILL
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State | IL
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Zip | 60403-0863
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Country | US
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Telephone | 815-782-8263
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Fax |
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Provider Business Mailing Address
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Address Line | 933 WATERFORD CT
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City | WILMINGTON
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State | IL
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Zip | 60481-2327
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149.024723
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License Number State | IL
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