Individual
BROCK OWEN BODENBENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCC
Contact information
Practice address
17951 JEFFERSON PARK RD STE 100, MIDDLEBURG HEIGHTS, OH 44130-8439
(440) 879-8517
Mailing address
17951 JEFFERSON PARK RD STE 100, MIDDLEBURG HEIGHTS, OH 44130-8439
(440) 879-8517
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
E.2001912
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0267340
—
OH
Enumeration date
04/19/2017
Last updated
11/21/2022
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