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Individual

STEWART HOCKENBERRY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
255 S 17TH ST STE 1909, PHILADELPHIA, PA 19103-6219
(215) 576-1728
(215) 576-1728
Mailing address
409 CARLTON AVE, WYNCOTE, PA 19095-2015
(215) 576-1728
(215) 576-1728

Taxonomy

Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
PS008448L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0102891000
PERSONAL CHOICE PROVIDER
PA
01
158128
VALUE OPTIONS
PA
01
243596
MANAGED HEALTH NETWORK
PA
01
7543181
AETNA HEALTH CARE
PA
01
H0122450
INDEPENDENCE BLUE CROSS
PA
Enumeration date
12/29/2006
Last updated
07/08/2007
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