Individual
MABEL KATHERINE BROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT, LPC, RN
Contact information
Practice address
2285 BENTON RD, SUITE D-202, BOSSIER CITY, LA 71111-7933
(318) 347-0486
(318) 965-0904
Mailing address
2285 BENTON RD, SUITE D-202, BOSSIER CITY, LA 71111-7933
(318) 347-0486
(318) 965-0904
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
2677
LA
106H00000X
Marriage & Family Therapist
Primary
392
LA
Other
Enumeration date
04/10/2008
Last updated
08/04/2016
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