Individual
JENNIFER LYN BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
444 S 44TH ST, OMAHA, NE 68131-1065
(402) 559-8943
(402) 559-5737
Mailing address
985450 NEBRASKA MEDICAL CTR, OMAHA, NE 68198-5450
(402) 559-8943
(402) 559-5737
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1116
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1116
STATE LICENSE
NE
Enumeration date
08/06/2007
Last updated
07/06/2012
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