Individual
LAURA BROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
1700 MCHENRY VILLAGE WAY STE 14, MODESTO, CA 95350-4339
(209) 204-6606
Mailing address
PO BOX 262, RIVERBANK, CA 95367-0262
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
CA
Other
Enumeration date
06/17/2010
Last updated
06/23/2010
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