Individual
MRS. MARILEA S BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
3305 MAIN ST STE 200, VANCOUVER, WA 98663-2250
(360) 798-8653
(360) 326-2277
Mailing address
3305 MAIN ST STE 200, VANCOUVER, WA 98663-2250
(360) 798-8653
(360) 326-2277
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL00004266
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12096728
ASHA NUMBER
WA
Enumeration date
11/28/2006
Last updated
10/15/2018
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