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Individual

JENNIFER HOOPER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
450 SAINT JOHN RD, SUITE 501, MICHIGAN CITY, IN 46360-7354
(219) 879-4621
Mailing address
105 HARRISON ST, LA PORTE, IN 46350-3763
(219) 879-4621

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34006121A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100163580A
IN
Enumeration date
02/27/2012
Last updated
02/27/2012
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