Individual
KAN'DACE LEN BROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
7126 WATERTROUT BAY, SAN ANTONIO, TX 78244-1778
(817) 291-6942
Mailing address
7126 WATERTROUT BAY, SAN ANTONIO, TX 78244-1778
(817) 291-6942
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
54904
TX
Other
Enumeration date
09/18/2019
Last updated
09/18/2019
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