Healthcare Provider Details

I. General information

NPI: 1174881817
Provider Name (Legal Business Name): LUCINDA LEE HOCKING MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2012
Last Update Date: 05/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2345 S HURON PKWY THE PARKWAY CENTER
ANN ARBOR MI
48104-5124
US

IV. Provider business mailing address

2345 S HURON PKWY THE PARKWAY CENTER
ANN ARBOR MI
48104-5124
US

V. Phone/Fax

Practice location:
  • Phone: 734-973-3030
  • Fax: 734-973-3057
Mailing address:
  • Phone: 734-973-3030
  • Fax: 734-973-3057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801064694
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: