Healthcare Provider Details

I. General information

NPI: 1255244471
Provider Name (Legal Business Name): BREANN PILAR HOCKENBURY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2909 E QUAKER ST
BROKEN ARROW OK
74014-3499
US

IV. Provider business mailing address

2909 E QUAKER ST
BROKEN ARROW OK
74014-3499
US

V. Phone/Fax

Practice location:
  • Phone: 539-218-6591
  • Fax:
Mailing address:
  • Phone: 539-218-6591
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-2854068
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: