Provider Demographics
NPI:1912084310
Name:HOOD, CAMILLE ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:CAMILLE
Middle Name:ANN
Last Name:HOOD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:491 COLUMBIA AVE E STE 4
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49014-5468
Mailing Address - Country:US
Mailing Address - Phone:269-962-9611
Mailing Address - Fax:269-962-9612
Practice Address - Street 1:491 COLUMBIA AVE E STE 4
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49014-5468
Practice Address - Country:US
Practice Address - Phone:269-962-9611
Practice Address - Fax:269-962-9612
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4101006336106H00000X
MI6301012986103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P62200Medicare PIN