Provider Demographics
NPI:1992444962
Name:HOOTEN, ALEXANDRA RHODES (PSYD)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:RHODES
Last Name:HOOTEN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:RHODES
Other - Last Name:GOUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:153 W KINDERTON WAY APT 108
Mailing Address - Street 2:
Mailing Address - City:BERMUDA RUN
Mailing Address - State:NC
Mailing Address - Zip Code:27006-7392
Mailing Address - Country:US
Mailing Address - Phone:513-518-0594
Mailing Address - Fax:
Practice Address - Street 1:4600 SMITH RD STE A6
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:OH
Practice Address - Zip Code:45212-2793
Practice Address - Country:US
Practice Address - Phone:513-518-0594
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-31
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHP.08249103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist