Individual
HOLLY BROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
4133 BEDINGTON LN, FORT WORTH, TX 76244-5791
(817) 862-1569
Mailing address
4133 BEDINGTON LN, FORT WORTH, TX 76244-5791
(817) 862-1569
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
14947
TX
Other
Enumeration date
08/27/2019
Last updated
08/27/2019
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