Provider Demographics
NPI:1093347080
Name:HOOD, JESSICA MARI
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:MARI
Last Name:HOOD
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 1:2500 MANN RD LOT 320
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48346-4226
Mailing Address - Country:US
Mailing Address - Phone:586-942-8066
Mailing Address - Fax:
Practice Address - Street 1:2500 MANN RD LOT 320
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48346-4226
Practice Address - Country:US
Practice Address - Phone:586-942-8066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-07
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician