Provider Demographics
NPI:1528704590
Name:HOCKADAY, CASSANDRA (RBT)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:HOCKADAY
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:296 MERCHANTS SQ
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:GA
Mailing Address - Zip Code:30132-5029
Mailing Address - Country:US
Mailing Address - Phone:470-391-2300
Mailing Address - Fax:470-592-6581
Practice Address - Street 1:296 MERCHANTS SQ
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:GA
Practice Address - Zip Code:30132-5029
Practice Address - Country:US
Practice Address - Phone:470-391-2300
Practice Address - Fax:470-592-6581
Is Sole Proprietor?:No
Enumeration Date:2022-05-11
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARBT-22-213686106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician