Individual
CHANDRA J BROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
120 GLEN HOLLY DR, ROSWELL, GA 30076-4422
(337) 254-9123
Mailing address
120 GLEN HOLLY DR, ROSWELL, GA 30076-4422
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP006447
GA
Other
Enumeration date
12/01/2011
Last updated
12/01/2011
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