Individual
JEANETTE R HOEKSEMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
1391 N BALDWIN AVE STE 200, MARION, IN 46952-1913
(765) 660-7900
(765) 671-7751
Mailing address
330 N WABASH AVE STE G-20, MARION, IN 46952-2605
(765) 660-7600
(765) 651-7313
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
20043405A
IN
1041C0700X
Clinical Social Worker
34004347A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001539402
ANTHEM
IN
05
—
300045435
—
IN
Enumeration date
01/23/2007
Last updated
12/11/2020
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