Individual
SONYA BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
40 SPRUCE ST, LEOMINSTER, MA 01453-3233
(978) 466-3820
(978) 466-3420
Mailing address
10 MECHANIC ST, WORCESTER, MA 01608-2420
(508) 792-5400
(508) 753-5051
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y10400
MEDICARE PTAN Y10400
MA
Enumeration date
07/14/2015
Last updated
07/14/2015
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