Provider Demographics
NPI:1356625180
Name:MOCKLER PSYCHOLOGY, P.A.
Entity type:Organization
Organization Name:MOCKLER PSYCHOLOGY, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:L
Authorized Official - Last Name:MOCKLER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:813-443-5722
Mailing Address - Street 1:608 W HORATIO ST
Mailing Address - Street 2:STE. A
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-4104
Mailing Address - Country:US
Mailing Address - Phone:813-443-5722
Mailing Address - Fax:
Practice Address - Street 1:608 W HORATIO ST
Practice Address - Street 2:STE. A
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-4104
Practice Address - Country:US
Practice Address - Phone:813-443-5722
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-28
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY8001103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty