Individual
MS. MCKENZIE MARIE BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
526 NW 24TH AVE, PORTLAND, OR 97210-3212
(720) 515-3296
Mailing address
526 NW 24TH AVE, PORTLAND, OR 97210-3212
(720) 515-3296
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L11505
OR
Other
Enumeration date
08/26/2019
Last updated
08/30/2024
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