Provider Demographics
NPI:1205219490
Name:HOOVER, RHONDA
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:
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 1:510 TRACI CIR
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:AL
Mailing Address - Zip Code:35135-1459
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:510 TRACI CIR
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:AL
Practice Address - Zip Code:35135-1459
Practice Address - Country:US
Practice Address - Phone:205-577-7837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-07
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALOTA1300224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant