Individual
ALICIA MOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15 RUGER CIR, LAKELAND, GA 31635-5268
(303) 524-5530
Mailing address
15 RUGER CIR, LAKELAND, GA 31635-5268
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
LBA0551
NV
Other
Enumeration date
12/13/2017
Last updated
10/30/2024
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