Provider Demographics
NPI:1811295975
Name:HOCH, THEODORE ANDREW (EDD)
Entity type:Individual
Prefix:DR
First Name:THEODORE
Middle Name:ANDREW
Last Name:HOCH
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2528 PAXTON ST
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-3416
Mailing Address - Country:US
Mailing Address - Phone:703-987-8928
Mailing Address - Fax:
Practice Address - Street 1:2528 PAXTON ST
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-3416
Practice Address - Country:US
Practice Address - Phone:703-987-8928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-14
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0811000959103TM1800X
VA0701003419101YP2500X
1-00-0054103K00000X
MD3053103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional