Provider Demographics
NPI:1093108003
Name:HOOVER, SANDRA KINDIG
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:KINDIG
Last Name:HOOVER
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 1:137 S CASSINGHAM RD
Mailing Address - Street 2:
Mailing Address - City:BEXLEY
Mailing Address - State:OH
Mailing Address - Zip Code:43209-1838
Mailing Address - Country:US
Mailing Address - Phone:614-560-5506
Mailing Address - Fax:
Practice Address - Street 1:2080 CITYGATE DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-3591
Practice Address - Country:US
Practice Address - Phone:614-445-3750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-16
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.00191651041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool