Provider Demographics
NPI:1396895306
Name:HOEBING, BRAD JOE (EDS)
Entity type:Individual
Prefix:MR
First Name:BRAD
Middle Name:JOE
Last Name:HOEBING
Suffix:
Gender:M
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 S HARRIS DR
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85204-6710
Mailing Address - Country:US
Mailing Address - Phone:480-545-7060
Mailing Address - Fax:480-926-7160
Practice Address - Street 1:1820 S HARRIS DR
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85204-6710
Practice Address - Country:US
Practice Address - Phone:480-545-7060
Practice Address - Fax:480-926-7160
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3776247103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist