Provider Demographics
NPI:1811446081
Name:BOCK, CARLI
Entity type:Individual
Prefix:
First Name:CARLI
Middle Name:
Last Name:BOCK
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 1:33464 SCHOENHERR RD STE 180
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48312-6392
Mailing Address - Country:US
Mailing Address - Phone:586-999-5917
Mailing Address - Fax:248-712-4381
Practice Address - Street 1:33464 SCHOENHERR RD STE 180
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48312-6392
Practice Address - Country:US
Practice Address - Phone:586-999-5917
Practice Address - Fax:248-712-4381
Is Sole Proprietor?:No
Enumeration Date:2016-09-28
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician