Individual
SEIJI BROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
4552 N CITRUS AVE, BOISE, ID 83713-9556
(208) 402-6974
Mailing address
4552 N CITRUS AVE, BOISE, ID 83713-9556
(208) 861-0233
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCPC-8176
ID
Other
Enumeration date
10/16/2018
Last updated
12/10/2024
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