Individual
DENISE MARIE VAN BROCKLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SSP, NCSP
Contact information
Practice address
230 S COURT ST, MEDINA, OH 44256-2275
(330) 723-7977
(330) 725-5177
Mailing address
230 S COURT ST, MEDINA, OH 44256-2275
(330) 723-7977
(330) 725-5177
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
4061936
AK
Other
Enumeration date
05/17/2022
Last updated
05/17/2022
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