Provider Demographics
NPI:1447532957
Name:BOCK, VICTORIA LYNN (MA)
Entity type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:LYNN
Last Name:BOCK
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:VICTORIA
Other - Middle Name:LYNN
Other - Last Name:COHRS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10820 HARNEY ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-2638
Mailing Address - Country:US
Mailing Address - Phone:727-251-1328
Mailing Address - Fax:
Practice Address - Street 1:10820 HARNEY ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-2638
Practice Address - Country:US
Practice Address - Phone:402-290-3731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-12
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-13-15011OtherBCBA CERTIFICATION