Basic Information
Provider Information
NPI: 1841522570
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOCQUARD
FirstName: EARL
MiddleName: E
NamePrefix: MR.
NameSuffix:  
Credential: MA LLP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4413 CORUNNA RD
Address2:  
City: FLINT
State: MI
PostalCode: 48532
CountryCode: US
TelephoneNumber: 8103555382
FaxNumber:  
Practice Location
Address1: 4413 CORUNNA RD
Address2:  
City: FLINT
State: MI
PostalCode: 48532
CountryCode: US
TelephoneNumber: 8106301152
FaxNumber: 8106309107
Other Information
ProviderEnumerationDate: 02/05/2010
LastUpdateDate: 11/13/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103TC1900X6301013542MIY Behavioral Health & Social Service ProvidersPsychologistCounseling

No ID Information.


Home