Doctor Name: | LINDA MOCK |
NPI Number: | 1053461756 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA |
License Number: | |
Business Practice Address: | 1100 Walnut St Owensboro, KY - 423012956 |
Business Phone Number: | 2706896500 |
Business Fax Number: | |
Mailing Address: | 1100 Walnut St, OWENSBORO |
State: | KY |
Postal Code: | 423012956 |
Phone Number: | 2706896500 |
Fax Number: | |
NPI Enumeration Date: | 01/12/2007 |
NPI Last Update Date: | 08/29/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |