MEDICARE: PATRICIA HOOVER

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	CSW.09925493	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CSW.09925493	OTHER	CO	DORA

General Provider Information

NPI Number	:	1023639085
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA HOOVER

Provider Business Mailing Address
First Line	:	1119 MOUNT VIEW LN
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907-4530
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1119 MOUNT VIEW LN
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907-4530
Country	:	US
Telephone Number	:	--
Fax Number	:

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

Provider Enumeration Date	:	04/30/2020
Last Update Date	:	04/30/2020

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Directions to “ PATRICIA HOOVER ” Practice Location

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