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Individual

SHELBY RAE HOOPER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3520 INDUSTRIAL AVE, FAIRBANKS, AK 99701-7376
(907) 290-6395
Mailing address
PO BOX 55189, NORTH POLE, AK 99705-0189
(219) 628-5565

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-100373
AK

Other

Enumeration date
09/30/2019
Last updated
12/28/2020
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