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Individual

DAVID CORBLY BROCKMAN III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC, ATR

Contact information

Practice address
10421 S CHURCH ST, CHICAGO, IL 60643-2940
(708) 568-1909
Mailing address
1334 W BRYN MAWR AVE APT 2, CHICAGO, IL 60660-0049
(513) 417-5035

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
178.021187
IL
221700000X
Art Therapist
24-718

Other

Enumeration date
10/02/2025
Last updated
10/02/2025
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