Individual
AMANDA JACQUELINE BROCKWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW, LCDC
Contact information
Practice address
9565 DIANA DR, EL PASO, TX 79924-6951
(915) 747-3605
Mailing address
201 E MAIN DR STE 600, EL PASO, TX 79901-1385
(915) 887-3410
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
63036
TX
Other
Enumeration date
10/29/2018
Last updated
10/29/2018
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