Individual
KEVIN BROCKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2960 CENTER ST NE, SALEM, OR 97301-4555
(971) 345-7376
Mailing address
2960 CENTER ST NE, SALEM, OR 97301-4555
(971) 345-7376
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
08/28/2024
Last updated
08/28/2024
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