Provider Demographics
NPI:1134240484
Name:HOOTMAN, JENNIFER MAE (PHD, ATC)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:MAE
Last Name:HOOTMAN
Suffix:
Gender:F
Credentials:PHD, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3004 WINDWARD DR NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30152-4668
Mailing Address - Country:US
Mailing Address - Phone:770-488-6038
Mailing Address - Fax:770-488-5486
Practice Address - Street 1:3004 WINDWARD DR NW
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30152-4668
Practice Address - Country:US
Practice Address - Phone:770-488-6038
Practice Address - Fax:770-488-5486
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744R1102XOther Service ProvidersSpecialistResearch Study