Provider Demographics
NPI:1043835291
Name:HOOVER, SARA (BS CRS)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:HOOVER
Suffix:
Gender:F
Credentials:BS CRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 WESTRIDGE RD STE 103
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:PA
Mailing Address - Zip Code:15501-1157
Mailing Address - Country:US
Mailing Address - Phone:814-444-9696
Mailing Address - Fax:
Practice Address - Street 1:445 WESTRIDGE RD STE 103
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:PA
Practice Address - Zip Code:15501-1157
Practice Address - Country:US
Practice Address - Phone:814-444-9696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-13
Last Update Date:2020-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA567-012175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Multi-Specialty