Provider Demographics
NPI:1295383313
Name:HOOVER, LIANA LUCILLE (LMFT)
Entity Type:Individual
Prefix:
First Name:LIANA
Middle Name:LUCILLE
Last Name:HOOVER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20882 W EASTVIEW WAY
Mailing Address - Street 2:
Mailing Address - City:BUCKEYE
Mailing Address - State:AZ
Mailing Address - Zip Code:85396-8362
Mailing Address - Country:US
Mailing Address - Phone:623-248-1704
Mailing Address - Fax:
Practice Address - Street 1:20882 W EASTVIEW WAY
Practice Address - Street 2:
Practice Address - City:BUCKEYE
Practice Address - State:AZ
Practice Address - Zip Code:85396-8362
Practice Address - Country:US
Practice Address - Phone:623-248-1704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-02
Last Update Date:2019-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMFT-15232106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZLMFT-15232OtherSTATE LICENSE