Individual
ALIVIA L MOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AAS, QMHS
Contact information
Practice address
915 S RIVERSIDE DR NE, MCCONNELSVILLE, OH 43756-9102
(740) 962-5204
(740) 962-3688
Mailing address
2845 BELL ST, ZANESVILLE, OH 43701-1720
(740) 454-9766
(740) 588-6452
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0389216
—
OH
Enumeration date
02/03/2020
Last updated
02/06/2020
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