Individual
AMY LYNN HOOTMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
2806 W FAWKESWAY DR, BLOOMINGTON, IN 47404-1211
(812) 719-3224
Mailing address
2806 W FAWKESWAY DR, BLOOMINGTON, IN 47404-1211
(812) 719-3224
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39001875A
IN
Other
Enumeration date
06/07/2020
Last updated
06/07/2020
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