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Individual

DONYA BROCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
SLP

Contact information

Practice address
1250 S A W GRIMES BLVD, ROUND ROCK, TX 78664-7429
(512) 310-7665
(512) 310-9228
Mailing address
1250 S A W GRIMES BLVD, ROUND ROCK, TX 78664-7429
(512) 310-7665
(512) 310-9228

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
16142
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0031DG
BLUE CROSS BLUE SHIELD
05
0944746-02
TN
Enumeration date
03/30/2012
Last updated
03/30/2012
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