Individual
MRS. PAULETTE ANN BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.C.S.W.
Contact information
Practice address
1900 E. MAIN, DEPARTMENT OF VETERAN'S AFFAIRS, DANVILLE, IL 61832-5100
(217) 554-5111
Mailing address
5111 N DUNCAN RD, CHAMPAIGN, IL 61822-9560
(217) 356-9712
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
IL
Other
Enumeration date
10/12/2006
Last updated
07/08/2007
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