| NPI | 1073641064 |
|---|---|
| Other Name | MICHAEL W BROCKMAN |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 15-10-21) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR 19-QMHA-I-01468) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2022-06-30 |