Provider Demographics
NPI:1457074510
Name:HOEKWATER, PATRICK JAMES
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:JAMES
Last Name:HOEKWATER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1760 MANLEY RD
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-9400
Mailing Address - Country:US
Mailing Address - Phone:419-573-5257
Mailing Address - Fax:419-318-1603
Practice Address - Street 1:1760 MANLEY RD
Practice Address - Street 2:
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-9400
Practice Address - Country:US
Practice Address - Phone:419-573-5257
Practice Address - Fax:419-318-1603
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-23
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.182095101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)