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Individual

MR. BROCK CONRAD KLEMENT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
2501 HANLEY RD STE 201, HUDSON, WI 54016-8786
(534) 544-5247
(534) 544-5248
Mailing address
527 13TH ST S APT 221, HUDSON, WI 54016-2157
(928) 814-3279

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LPC-18611
AZ
101YP2500X
Professional Counselor
Primary
10038-125
WI
101YP2500X
Professional Counselor
2751
MN

Other

Enumeration date
11/03/2021
Last updated
11/02/2022
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