Individual
MRS. LISA G BROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LPC, LMFT
Contact information
Practice address
2200 S WALDRON RD, FORT SMITH, AR 72903-3088
(479) 242-7111
Mailing address
8600 GATEHOUSE WAY, FORT SMITH, AR 72916-6022
(479) 461-7789
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
P1808107
AR
106H00000X
Marriage & Family Therapist
M1807017
AR
Other
Enumeration date
08/25/2014
Last updated
05/17/2024
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