Individual
BIANCA L HOOTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.P.S.S
Contact information
Practice address
919 2ND ST NE, CANTON, OH 44704-1132
(330) 454-7917
Mailing address
1516 17TH ST NW, CANTON, OH 44703-1055
(330) 915-1622
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00436
CERTIFIED PEER SUPPORTER
OH
Enumeration date
10/15/2018
Last updated
10/15/2018
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