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Individual
STEPHEN E MOCK
Active
Individual
STEPHEN E MOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
AT000199L
PA
231H00000X
Audiologist
Primary
AT000199L
PA
231HA2400X
Assistive Technology Practitioner Audiologist
AT000199L
PA
231HA2500X
Assistive Technology Supplier Audiologist
AT000199L
PA
237600000X
Audiologist-Hearing Aid Fitter
AT000199L
PA
332S00000X
Hearing Aid Equipment
AT000199L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012749680001
—
PA
01
—
282868
BLUE SHIELD PROVIDER ID
PA
01
—
AT000199L
LICENSE NUMBER
PA
Enumeration date
10/13/2006
Last updated
01/15/2009
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