Provider Demographics
NPI:1629719588
Name:HOOD, MISTY MARIE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MISTY
Middle Name:MARIE
Last Name:HOOD
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 45
Mailing Address - Street 2:
Mailing Address - City:HONEY GROVE
Mailing Address - State:TX
Mailing Address - Zip Code:75446-0045
Mailing Address - Country:US
Mailing Address - Phone:903-640-3147
Mailing Address - Fax:
Practice Address - Street 1:321 S 2ND ST
Practice Address - Street 2:
Practice Address - City:BONHAM
Practice Address - State:TX
Practice Address - Zip Code:75418-4701
Practice Address - Country:US
Practice Address - Phone:903-583-5528
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107284235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist