Provider Demographics
NPI:1760879373
Name:HOCK, GRETA SUE
Entity Type:Individual
Prefix:MRS
First Name:GRETA
Middle Name:SUE
Last Name:HOCK
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 1:126 RAINTREE BLVD
Mailing Address - Street 2:
Mailing Address - City:NICEVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32578-3908
Mailing Address - Country:US
Mailing Address - Phone:850-218-5682
Mailing Address - Fax:
Practice Address - Street 1:126 RAINTREE BLVD
Practice Address - Street 2:
Practice Address - City:NICEVILLE
Practice Address - State:FL
Practice Address - Zip Code:32578-3908
Practice Address - Country:US
Practice Address - Phone:850-218-5682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-21
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency