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Individual

MS. TRAEQUANDA BROCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LGSW, LMSW

Contact information

Practice address
440 PENN ST NE APT 520, WASHINGTON, DC 20002-8373
(518) 364-4481
Mailing address
1401 MERCANTILE LN STE 433, UPPER MARLBORO, MD 20774-4301
(518) 364-4481
(240) 823-1424

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
26217
MD
104100000X
Social Worker
44SL07023200
NJ
104100000X
Social Worker
LG50083546
DC
374J00000X
Doula

Other

Enumeration date
09/19/2023
Last updated
09/19/2023
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