Individual
CAYLIE BROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
2500 S POWER RD,, BLDG 9, STE 222, MESA, AZ 85209-6690
(425) 999-6853
Mailing address
10030 E NARANJA AVE, MESA, AZ 85209-7929
(425) 999-6853
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LAC-20492
AZ
Other
Enumeration date
01/06/2022
Last updated
01/06/2022
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