Provider Demographics
NPI:1427096312
Name:HOCKENSMITH, SHELLEY L (PT)
Entity type:Individual
Prefix:MRS
First Name:SHELLEY
Middle Name:L
Last Name:HOCKENSMITH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MRS
Other - First Name:SHELLEY
Other - Middle Name:L
Other - Last Name:REGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:5357 N CAMINO DE OESTE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-9704
Mailing Address - Country:US
Mailing Address - Phone:520-820-9924
Mailing Address - Fax:
Practice Address - Street 1:140 W FORT LOWELL RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705-3812
Practice Address - Country:US
Practice Address - Phone:520-591-5346
Practice Address - Fax:888-780-0154
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6669225100000X
AZLPT-0066692251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist