Healthcare Provider Details

I. General information

NPI: 1063909091
Provider Name (Legal Business Name): GARRISON RILEY HOCKER BCBA, LBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2018
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

511 W LINCOLN AVE
GOSHEN IN
46526-2430
US

IV. Provider business mailing address

4525 E CLINTON TRL
EATON RAPIDS MI
48827-8368
US

V. Phone/Fax

Practice location:
  • Phone: 574-387-4313
  • Fax:
Mailing address:
  • Phone: 269-501-6587
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: