Provider Demographics
NPI:1588065973
Name:HOOPER, CARYN (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:CARYN
Middle Name:
Last Name:HOOPER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:CARYN
Other - Middle Name:
Other - Last Name:CARROLL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:1501 S MAGNOLIA ST
Mailing Address - Street 2:APT. 205
Mailing Address - City:WOODVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75979-5652
Mailing Address - Country:US
Mailing Address - Phone:325-201-5133
Mailing Address - Fax:
Practice Address - Street 1:440 HIGHWAY 59 LOOP S
Practice Address - Street 2:#104
Practice Address - City:LIVINGSTON
Practice Address - State:TX
Practice Address - Zip Code:77351-9096
Practice Address - Country:US
Practice Address - Phone:936-328-8148
Practice Address - Fax:936-327-2491
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-04
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106068235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist