Individual
TAMMILA R BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2100 CHARLIE HALL BLVD, CHARLESTON, SC 29414-5832
(843) 852-4100
Mailing address
403 STONY LANDING RD, MONCKS CORNER, SC 29461-3967
(843) 761-8282
(843) 761-7308
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760596480
—
SC
Enumeration date
11/09/2020
Last updated
09/23/2024
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