Provider Demographics
NPI:1073235768
Name:HOCHBURGER, ISABELLA MARIA
Entity Type:Individual
Prefix:
First Name:ISABELLA
Middle Name:MARIA
Last Name:HOCHBURGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2741 4TH AVE N
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-7823
Mailing Address - Country:US
Mailing Address - Phone:215-813-5513
Mailing Address - Fax:
Practice Address - Street 1:2741 4TH AVE N
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-7823
Practice Address - Country:US
Practice Address - Phone:215-813-5513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-19
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician