Provider Demographics
NPI:1043465784
Name:HOOFNAGLE, KYLE ROLLINS (LMHC)
Entity Type:Individual
Prefix:MS
First Name:KYLE
Middle Name:ROLLINS
Last Name:HOOFNAGLE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3372 BALSAM DR.
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-2014
Mailing Address - Country:US
Mailing Address - Phone:407-657-3853
Mailing Address - Fax:
Practice Address - Street 1:3372 BALSAM DR.
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-2014
Practice Address - Country:US
Practice Address - Phone:407-657-3853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-21
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8594103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst