Individual
MS. BRENDA C. ROCKWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
3930 S NOVA RD STE 307, PORT ORANGE, FL 32127-9293
(386) 866-2988
Mailing address
1423 HARNDEN RD W, PORT ORANGE, FL 32129-7415
(386) 256-6129
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH14744
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020114000
—
FL
Enumeration date
09/14/2013
Last updated
09/15/2020
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