Provider Demographics
NPI:1427476316
Name:MOCK, MARIA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:MOCK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7463 OLD RIVER DR
Mailing Address - Street 2:
Mailing Address - City:BLACKLICK
Mailing Address - State:OH
Mailing Address - Zip Code:43004-7126
Mailing Address - Country:US
Mailing Address - Phone:614-668-9338
Mailing Address - Fax:
Practice Address - Street 1:7463 OLD RIVER DR
Practice Address - Street 2:
Practice Address - City:BLACKLICK
Practice Address - State:OH
Practice Address - Zip Code:43004-7126
Practice Address - Country:US
Practice Address - Phone:614-668-9338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-28
Last Update Date:2025-11-20
Deactivation Date:2024-09-03
Deactivation Code:
Reactivation Date:2025-11-20
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health