Provider Demographics
NPI:1700801008
Name:HOOVER, JACQUELINE MARIE (MS, LCGC)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:MARIE
Last Name:HOOVER
Suffix:
Gender:F
Credentials:MS, LCGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12311 PERRY HIGHWAY
Mailing Address - Street 2:WEXFORD HEALTH AND WELLNESS PAVILLION, 2ND FLOOR
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090
Mailing Address - Country:US
Mailing Address - Phone:878-332-4401
Mailing Address - Fax:878-332-4496
Practice Address - Street 1:12311 PERRY HIGHWAY
Practice Address - Street 2:WEXFORD HEALTH AND WELLNESS PAVILLION, 2ND FLOOR
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090
Practice Address - Country:US
Practice Address - Phone:412-692-5935
Practice Address - Fax:412-692-6472
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS