1235285792 NPI number — MRS. MELISSA A HOOPER MS CCC SLP

Table of content: MRS. MELISSA A HOOPER MS CCC SLP (NPI 1235285792)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235285792 NPI number — MRS. MELISSA A HOOPER MS CCC SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOOPER
Provider First Name:
MELISSA
Provider Middle Name:
A
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MS CCC SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ZETS
Provider Other First Name:
MELISSA
Provider Other Middle Name:
A
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
MS CCC SLP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1235285792
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/03/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
280 CENTRAL AVE
Provider Second Line Business Mailing Address:
W123 THOMPSON HALL
Provider Business Mailing Address City Name:
FREDONIA
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14063-1127
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
716-673-3203
Provider Business Mailing Address Fax Number:
716-673-3235

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
280 CENTRAL AVE
Provider Second Line Business Practice Location Address:
W123 THOMPSON HALL
Provider Business Practice Location Address City Name:
FREDONIA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14063-1127
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-673-3203
Provider Business Practice Location Address Fax Number:
716-673-3235
Provider Enumeration Date:
01/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  009919-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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