Provider Demographics
NPI:1558931782
Name:HOYDIC, BROOKE ANN
Entity Type:Individual
Prefix:MISS
First Name:BROOKE
Middle Name:ANN
Last Name:HOYDIC
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 1:2148 W ENGEL RD
Mailing Address - Street 2:
Mailing Address - City:WEST BRANCH
Mailing Address - State:MI
Mailing Address - Zip Code:48661-9224
Mailing Address - Country:US
Mailing Address - Phone:989-889-1097
Mailing Address - Fax:
Practice Address - Street 1:5039 VILLA LINDE PKWY STE 30
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3450
Practice Address - Country:US
Practice Address - Phone:503-930-4847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-29
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician