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Individual
TIMOTHY STOCKDALE
Active
Individual
TIMOTHY STOCKDALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, CCC-SLP
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
10906563-4102
UT
235Z00000X
Speech-Language Pathologist
SA 14171
FL
235Z00000X
Speech-Language Pathologist
Primary
SA24176
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018980200
—
FL
05
—
129166200
—
FL
01
—
4TM44
BLUE CROSS BLUE SHIELD
FL
01
—
Y911W
BCBS
FL
Enumeration date
09/23/2016
Last updated
01/12/2026
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