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Individual

MARIA TONITA BROCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
L.I.S.W.

Contact information

Practice address
1100 CARDENAS DR SE, ALBUQUERQUE, NM 87108-4809
(505) 266-0992
Mailing address
1121 IRON AVE SW, ALBUQUERQUE, NM 87102-3753
(505) 908-0015

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-05878
NM
171100000X
Acupuncturist
CADS-012
NM

Other

Enumeration date
11/18/2009
Last updated
11/18/2009
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