Provider Demographics
NPI:1760939011
Name:HOCKER, ELIZABETH DIANE (PLPC)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:DIANE
Last Name:HOCKER
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 JOHNSON CT
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:MO
Mailing Address - Zip Code:65010-9473
Mailing Address - Country:US
Mailing Address - Phone:573-823-6992
Mailing Address - Fax:
Practice Address - Street 1:203 JOHNSON CT
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:MO
Practice Address - Zip Code:65010-9473
Practice Address - Country:US
Practice Address - Phone:573-823-6992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-03
Last Update Date:2016-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014037901101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional