Individual
MRS. AMY ELIZABETH BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY S; NCSP
Contact information
Practice address
PO BOX 1217, WISE, VA 24293-1217
(276) 328-8017
(276) 328-8017
Mailing address
PO BOX 1217, WISE, VA 24293-1217
(276) 328-8017
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
0813000402
VA
Other
Enumeration date
08/10/2017
Last updated
01/07/2019
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