Provider Demographics
NPI:1376907725
Name:HOEKZEMA, ALIX (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ALIX
Middle Name:
Last Name:HOEKZEMA
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 CROSS POINTE RD
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-6691
Mailing Address - Country:US
Mailing Address - Phone:614-407-6513
Mailing Address - Fax:
Practice Address - Street 1:750 CROSS POINTE RD
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-6691
Practice Address - Country:US
Practice Address - Phone:614-407-6513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-12
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07005235Z00000X
OH14036676235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist