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Individual

MR. BROOKS BENJAMIN ROLL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
1420 STONEHOLLOW DR STE C, KINGWOOD, TX 77339-2494
(281) 812-7529
(281) 812-3777
Mailing address
1420 STONEHOLLOW DR STE C, KINGWOOD, TX 77339-2494
(281) 812-7529
(281) 812-3777

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
39450
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
TXB102955
TRAILBLAZER
TX
Enumeration date
08/31/2006
Last updated
04/18/2012
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