Provider Demographics
NPI:1043812811
Name:HOOKS, MIA
Entity Type:Individual
Prefix:
First Name:MIA
Middle Name:
Last Name:HOOKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3092 SPRING HILL PKWY SE APT I
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-4777
Mailing Address - Country:US
Mailing Address - Phone:678-927-7836
Mailing Address - Fax:
Practice Address - Street 1:3092 SPRING HILL PKWY SE APT I
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-4777
Practice Address - Country:US
Practice Address - Phone:678-927-7836
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program