Provider Demographics
NPI:1598917684
Name:OCKMAN, AZADEH ALAVI (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:AZADEH
Middle Name:ALAVI
Last Name:OCKMAN
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 1:235 BLACKBERRY DR
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-9463
Mailing Address - Country:US
Mailing Address - Phone:504-390-2908
Mailing Address - Fax:
Practice Address - Street 1:235 BLACKBERRY DR
Practice Address - Street 2:
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-9463
Practice Address - Country:US
Practice Address - Phone:504-390-2908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-21
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5667235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist