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Individual

DOROTHY MARIE BROCCO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW,LCSW,CBT,BCD

Contact information

Practice address
1600 LIBERTY PLACE, STE. 2, LAKEVIEW BUSINESS PARK, SICKLERVILLE, NJ 08081
(856) 979-9060
(856) 302-3068
Mailing address
217 CHERRYWOOD DR, LAUREL SPRINGS, NJ 08021-5605
(856) 566-0248
(856) 566-0248

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC00162600
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
398500
VALUE OPTIONS
NJ
Enumeration date
12/05/2006
Last updated
09/03/2014
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