Individual
CARY ELIZABETH LEATHERWOOD BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1414 DUG GAP RD, DALTON, GA 30720-5007
(706) 279-0405
Mailing address
253 CASH RD NE, CALHOUN, GA 30701-9717
(706) 676-0262
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC010903
—
Other
Enumeration date
04/09/2019
Last updated
04/09/2019
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