| NPI | 1124720123 |
|---|---|
| Former Name | BRENDA LEE BLOCK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 11364-125) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 7261-226) |
| Enumeration Date | 2023-03-21 |
| Last Update Date | 2025-01-15 |