Provider Demographics
NPI:1629580360
Name:HOKE, JODY LYNN
Entity Type:Individual
Prefix:
First Name:JODY
Middle Name:LYNN
Last Name:HOKE
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 1:634 ROYALL AVE
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-5083
Mailing Address - Country:US
Mailing Address - Phone:832-654-7600
Mailing Address - Fax:
Practice Address - Street 1:5823 BOWEN DANIEL DR UNIT 1103
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33616-1471
Practice Address - Country:US
Practice Address - Phone:832-654-7600
Practice Address - Fax:832-654-7600
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-03
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25167235Z00000X
IL146.010153235Z00000X
SC6193235Z00000X
FLSA15048235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist