Provider Demographics
NPI:1598531519
Name:HOOBLER, CHARLENE LOUISE (PEER MENTOR)
Entity Type:Individual
Prefix:
First Name:CHARLENE
Middle Name:LOUISE
Last Name:HOOBLER
Suffix:
Gender:F
Credentials:PEER MENTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1355 SW 2ND ST APT 102
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:OR
Mailing Address - Zip Code:97801-4171
Mailing Address - Country:US
Mailing Address - Phone:458-300-6193
Mailing Address - Fax:
Practice Address - Street 1:920 SW FRAZER AVE STE 212
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:OR
Practice Address - Zip Code:97801-2802
Practice Address - Country:US
Practice Address - Phone:541-429-4940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-30
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist