Individual
MRS. BROOK ELIZABETH BODENHAMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LCDC
Contact information
Practice address
204 W TRAILMOOR DR, FREDERICKSBURG, TX 78624-3423
(210) 818-8819
Mailing address
204 W TRAILMOOR DR, FREDERICKSBURG, TX 78624-3423
(210) 818-8819
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
13434
TX
1041C0700X
Clinical Social Worker
Primary
52375
TX
Other
Enumeration date
04/15/2020
Last updated
04/15/2020
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