Provider Demographics
NPI:1306144548
Name:HOCKENBERRY, KYLIE GRACE
Entity type:Individual
Prefix:MISS
First Name:KYLIE
Middle Name:GRACE
Last Name:HOCKENBERRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 PLATTE ST
Mailing Address - Street 2:APT 440
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-6115
Mailing Address - Country:US
Mailing Address - Phone:586-489-5064
Mailing Address - Fax:
Practice Address - Street 1:1550 PLATTE ST
Practice Address - Street 2:APT 440
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80202-6115
Practice Address - Country:US
Practice Address - Phone:586-489-5064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-12
Last Update Date:2011-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist