Provider Demographics
NPI:1174012165
Name:BOCK, CHELSEA (COTA)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:BOCK
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7930 W LINCOLN ST NE
Mailing Address - Street 2:
Mailing Address - City:MASURY
Mailing Address - State:OH
Mailing Address - Zip Code:44438-9780
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:350 IRIS DR
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93906-3514
Practice Address - Country:US
Practice Address - Phone:831-449-1515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-04
Last Update Date:2018-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant