Provider Demographics
NPI:1053915850
Name:HOOKER, TAYLOR RAE (MS, CTRS, NBC-HWC)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:RAE
Last Name:HOOKER
Suffix:
Gender:F
Credentials:MS, CTRS, NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1144 PARSONAGE ST
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-3304
Mailing Address - Country:US
Mailing Address - Phone:757-286-2029
Mailing Address - Fax:
Practice Address - Street 1:160 MINE LAKE CT
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-6417
Practice Address - Country:US
Practice Address - Phone:800-516-0975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-23
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
A-3084110171400000X
66891225800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Multi-Specialty
No225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
A3084110OtherNBC-HWC