Individual
YVONNE BROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CAC-AD
Contact information
Practice address
1308 W ST NE, WASHINGTON, DC 20018-3503
(301) 821-3805
Mailing address
1308 W ST NE, WASHINGTON, DC 20018-3503
(301) 821-3805
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ACO340
MD
171M00000X
Case Manager/Care Coordinator
AC0340
MD
171W00000X
Contractor
ACO340
MD
174H00000X
Health Educator
ACO340
MD
225C00000X
Rehabilitation Counselor
ACO340
MD
Other
Enumeration date
06/13/2014
Last updated
06/13/2014
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