Provider Demographics
NPI:1245735000
Name:BOCOCK, BRITTANY MARIE
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:MARIE
Last Name:BOCOCK
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 1:11954 LEE HWY
Mailing Address - Street 2:
Mailing Address - City:FINCASTLE
Mailing Address - State:VA
Mailing Address - Zip Code:24090-4458
Mailing Address - Country:US
Mailing Address - Phone:540-309-5759
Mailing Address - Fax:
Practice Address - Street 1:1630 BRAEBURN DR
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-7371
Practice Address - Country:US
Practice Address - Phone:540-676-5744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-26
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst