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Individual

MR. CHARLES BROCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
JURIST DOCTOR

Contact information

Practice address
8706 JEFFERSON HWY STE A, BATON ROUGE, LA 70809-2233
(225) 926-9706
Mailing address
210 PEAR TREE CIR, BROUSSARD, LA 70518-7240
(337) 419-6227

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
01/25/2016
Last updated
03/25/2022
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