Provider Demographics
NPI:1124402367
Name:HOOTER, ANNE (LMT)
Entity type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:
Last Name:HOOTER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 W. AIRLINE HWY
Mailing Address - Street 2:STE F
Mailing Address - City:LAPLACE
Mailing Address - State:LA
Mailing Address - Zip Code:70068-3701
Mailing Address - Country:US
Mailing Address - Phone:504-251-8603
Mailing Address - Fax:
Practice Address - Street 1:1101 W. AIRLINE HWY
Practice Address - Street 2:STE F
Practice Address - City:LA PLACE
Practice Address - State:LA
Practice Address - Zip Code:70068-3701
Practice Address - Country:US
Practice Address - Phone:504-251-8603
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-17
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6988225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist