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 | 2024-07-01 |