Basic Information
| Provider Information | |||||||||
| NPI: | 1033127600 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOOPER | ||||||||
| FirstName: | MELANIE | ||||||||
| MiddleName: | SUSAN | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | MSW LMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 724 CARPENTER ST | ||||||||
| Address2: | |||||||||
| City: | NORTHVILLE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48167 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2487678420 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 8623 N WAYNE RD | ||||||||
| Address2: | HEGIRA PROGRAMS INC SUITE 123 | ||||||||
| City: | WESTLAND | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48185 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7343670469 | ||||||||
| FaxNumber: | 7343670791 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/03/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 6801079631 | MI | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.