MS. Tracey E Kock, ITDS

NPI #1558624312 in Land O Lakes, Florida

Provider Information

NPI Number: 1558624312
Entity Type: Individual
Name: MS. Tracey E Kock, ITDS
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Developmental Therapist
Credential: ITDS
Enumeration Date: Jun 18, 2012
Last Updated: Jun 18, 2012

Practice Location

Address: 21113 LAKE TALIA BLVD
City: Land O Lakes
State: Florida
ZIP Code: 34638-3738
Phone: (813) 873-1936

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker	104100000X
Developmental Therapist	222Q00000X	Primary

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