Healthcare Provider Details

I. General information

NPI: 1104237783
Provider Name (Legal Business Name): AIMEE HOCKMAN LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2014
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9940 ALVATON ROAD
ALVATON KY
42122
US

IV. Provider business mailing address

9940 ALVATON ROAD
ALVATON KY
42122
US

V. Phone/Fax

Practice location:
  • Phone: 270-746-6600
  • Fax: 270-842-9008
Mailing address:
  • Phone: 270-746-6600
  • Fax: 270-842-9008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number105301
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: