Provider Demographics
NPI:1376246066
Name:HOCKENBERRY, BROOKE ALEXIS (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:ALEXIS
Last Name:HOCKENBERRY
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 1:104 BROOKDALE DR
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26508-8830
Mailing Address - Country:US
Mailing Address - Phone:740-381-7038
Mailing Address - Fax:
Practice Address - Street 1:104 BROOKDALE DR
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26508-8830
Practice Address - Country:US
Practice Address - Phone:740-381-7038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-23
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2381235Z00000X
MD10769235Z00000X
MO2023007281235Z00000X
WVSLP-2319235Z00000X
VA2202011624235Z00000X
IL146.017303235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist