Individual
BRENDA BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 OCEAN AVE, RAYMOND, WA 98577-3016
(360) 942-2303
Mailing address
300 OCEAN AVE, RAYMOND, WA 98577-3016
(360) 942-2303
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CG60898113
WA
Other
Enumeration date
11/30/2018
Last updated
11/30/2018
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