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Individual

REBECCA BROCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BCBA

Contact information

Practice address
6711 NE 182ND ST UNIT D306, KENMORE, WA 98028-5006
(919) 599-4570
Mailing address
6711 NE 182ND ST UNIT D306, KENMORE, WA 98028-5006
(919) 599-4570

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
WA
106E00000X
Assistant Behavior Analyst
0-17-7638
NC

Other

Enumeration date
05/11/2017
Last updated
12/05/2018
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