Provider Demographics
NPI:1609365956
Name:HOOVER, KABRIEL DUANE
Entity Type:Individual
Prefix:MR
First Name:KABRIEL
Middle Name:DUANE
Last Name:HOOVER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2411 EMBLEM ST
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89436-9171
Mailing Address - Country:US
Mailing Address - Phone:775-335-6953
Mailing Address - Fax:
Practice Address - Street 1:2411 EMBLEM ST
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89436-9171
Practice Address - Country:US
Practice Address - Phone:775-335-6953
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-02
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician