Provider Demographics
NPI:1871483487
Name:BROCK, HILARY SHAE (MOT/L)
Entity type:Individual
Prefix:
First Name:HILARY
Middle Name:SHAE
Last Name:BROCK
Suffix:
Gender:F
Credentials:MOT/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 ASHCREEK AVE
Mailing Address - Street 2:
Mailing Address - City:LEWIS CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:43035-8451
Mailing Address - Country:US
Mailing Address - Phone:614-946-1921
Mailing Address - Fax:
Practice Address - Street 1:2121 ASHCREEK AVE
Practice Address - Street 2:
Practice Address - City:LEWIS CENTER
Practice Address - State:OH
Practice Address - Zip Code:43035-8451
Practice Address - Country:US
Practice Address - Phone:614-946-1921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH007539225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist