Provider Demographics
NPI:1700362308
Name:HOOTEN, KACY (AUD)
Entity Type:Individual
Prefix:DR
First Name:KACY
Middle Name:
Last Name:HOOTEN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 MAIN ST STE 15
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-2868
Mailing Address - Country:US
Mailing Address - Phone:303-776-8748
Mailing Address - Fax:303-684-9915
Practice Address - Street 1:2105 ACADEMY CIR STE 100
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-1664
Practice Address - Country:US
Practice Address - Phone:719-591-2763
Practice Address - Fax:719-591-2484
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-17
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty