Healthcare Provider Details

I. General information

NPI: 1972240927
Provider Name (Legal Business Name): AUDREY HOCHSTETLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2022
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32730 WALKER RD STE I4
AVON LAKE OH
44012-2235
US

IV. Provider business mailing address

32730 WALKER RD STE I4
AVON LAKE OH
44012-2235
US

V. Phone/Fax

Practice location:
  • Phone: 440-634-1668
  • Fax:
Mailing address:
  • Phone: 440-634-2235
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: