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Individual

MR. BRANDON JAMES MOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ATR-BC, LPC, LMFT

Contact information

Practice address
480 S ROGERS RD, OLATHE, KS 66062-1706
(913) 324-3683
(913) 780-3387
Mailing address
480 S ROGERS RD, OLATHE, KS 66062-1706
(913) 324-3683
(913) 780-3387

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
2002008097
MO
106H00000X
Marriage & Family Therapist
Primary
684
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
684
LMFT
KS
Enumeration date
12/06/2006
Last updated
09/07/2011
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