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Individual

MR. TRAVIS BLOCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M. ED., ED.S., NCSP

Contact information

Practice address
56100 BITTERSWEET RD, MISHAWAKA, IN 46545-7715
(574) 255-9347
Mailing address
56100 BITTERSWEET RD, MISHAWAKA, IN 46545-7715
(574) 309-2970

Taxonomy

Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
1042599
IN

Other

Enumeration date
03/31/2009
Last updated
09/25/2024
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