Provider Demographics
NPI:1205044054
Name:HOCK, SUSAN MERVIN (MA)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:MERVIN
Last Name:HOCK
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1808 GRENADA BLVD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-6314
Mailing Address - Country:US
Mailing Address - Phone:865-693-0000
Mailing Address - Fax:865-693-0000
Practice Address - Street 1:1225 E WEISGARBER RD
Practice Address - Street 2:STE 180 SOUTH
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-2604
Practice Address - Country:US
Practice Address - Phone:865-584-5558
Practice Address - Fax:865-584-6607
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNSP0000000294235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist