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Individual

PATRICIA LYNN KLOCKO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMHC

Contact information

Practice address
728 NE 7TH ST, TRENTON, FL 32693-3637
(352) 374-5600
Mailing address
3469 SE 80TH AVE, NEWBERRY, FL 32669-7001
(352) 221-0369

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
MH24009
FL
101Y00000X
Counselor

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MH24009
FLORIDA BOARD OF CLINICAL SOCIAL WORK
FL
Enumeration date
09/27/2021
Last updated
07/16/2024
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