Provider Demographics
NPI:1326320078
Name:HOOCK, MARSHA KAY (TEACHER)
Entity Type:Individual
Prefix:MRS
First Name:MARSHA
Middle Name:KAY
Last Name:HOOCK
Suffix:
Gender:F
Credentials:TEACHER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 HUNTINGTON KNLS
Mailing Address - Street 2:
Mailing Address - City:WOODWARD
Mailing Address - State:OK
Mailing Address - Zip Code:73801-9714
Mailing Address - Country:US
Mailing Address - Phone:580-256-8280
Mailing Address - Fax:
Practice Address - Street 1:1023 10TH ST
Practice Address - Street 2:
Practice Address - City:WOODWARD
Practice Address - State:OK
Practice Address - Zip Code:73801-3133
Practice Address - Country:US
Practice Address - Phone:580-254-4603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-19
Last Update Date:2011-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK004717103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK03K00000XMedicaid