Individual
MICHELLE MOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
12799 MAGNOLIA ST, BLAKELY, GA 39823-2315
(229) 274-2206
Mailing address
1120 W BROAD AVE # A, ALBANY, GA 31707-4397
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN106941
GA
Other
Enumeration date
01/22/2008
Last updated
02/04/2008
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