Individual
ALYSSA MOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1539 ALAMEDA AVE, LAKEWOOD, OH 44107-4922
(330) 519-9320
Mailing address
1539 ALAMEDA AVE, LAKEWOOD, OH 44107-4922
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
COND.2015260-SP
OH
Other
Enumeration date
09/18/2015
Last updated
01/08/2020
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