Individual
OLIVIA BROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11607 SOUTHFORK AVE, BATON ROUGE, LA 70816-5220
(888) 880-9270
Mailing address
9564 LEWIS ST, BATON ROUGE, LA 70807-3850
(225) 223-0153
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
LA
Other
Enumeration date
06/06/2025
Last updated
06/06/2025
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