| NPI | 1033621669 |
|---|---|
| Former Name | RONNIE DEAN HOOTEN |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 19649) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MD 19649) |
| 1041C0700X Social Worker, Clinical (Licence: RI ISW03124) | |
| Enumeration Date | 2017-11-06 |
| Last Update Date | 2021-10-15 |