Provider Demographics
NPI:1790833275
Name:HOOD, JENNIFER J (MA, MFT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:J
Last Name:HOOD
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 E HASKELL ST
Mailing Address - Street 2:STE A
Mailing Address - City:WINNEMUCCA
Mailing Address - State:NV
Mailing Address - Zip Code:89445
Mailing Address - Country:US
Mailing Address - Phone:775-623-0550
Mailing Address - Fax:775-623-3282
Practice Address - Street 1:51 E HASKELL ST
Practice Address - Street 2:STE A
Practice Address - City:WINNEMUCCA
Practice Address - State:NV
Practice Address - Zip Code:89445
Practice Address - Country:US
Practice Address - Phone:775-623-0550
Practice Address - Fax:775-623-3282
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0882106H00000X
AK255106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMH0150Medicaid