Provider Demographics
NPI:1194163899
Name:HOOPS, KERRY MICHELLE (MA, BCBA)
Entity type:Individual
Prefix:
First Name:KERRY
Middle Name:MICHELLE
Last Name:HOOPS
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Gender:F
Credentials:MA, BCBA
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Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1210 FOURIER DR
Mailing Address - Street 2:SUITE #100
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53717-1969
Mailing Address - Country:US
Mailing Address - Phone:608-662-9327
Mailing Address - Fax:608-662-9041
Practice Address - Street 1:1141 W MAIN AVE
Practice Address - Street 2:SUITE #201
Practice Address - City:DE PERE
Practice Address - State:WI
Practice Address - Zip Code:54115-9345
Practice Address - Country:US
Practice Address - Phone:920-338-1610
Practice Address - Fax:920-338-1616
Is Sole Proprietor?:No
Enumeration Date:2013-06-05
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI63-140103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst