Individual
SHALENA CHANTEL BROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
509 ABRAHAM CT, IRVING, TX 75060-6961
(469) 412-5140
(214) 614-4153
Mailing address
509 ABRAHAM CT, IRVING, TX 75060-6961
(469) 412-5140
(214) 614-4153
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
54859
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22004798
TEXAS HEALTH STEPS
TX
Enumeration date
08/31/2014
Last updated
08/31/2014
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