Individual
KATHRYN M BROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4116 SKYLINE LOOP NE, RIO RANCHO, NM 87144-1609
(817) 729-9099
Mailing address
4116 SKYLINE LOOP NE, RIO RANCHO, NM 87144-1609
(817) 729-9099
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C-11496
NM
261QM0850X
Adult Mental Health Clinic/Center
C-11496
NM
Other
Enumeration date
11/23/2021
Last updated
12/23/2024
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