| NPI | 1205316031 |
|---|---|
| Former Name | BROOKE BLOKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: IA 110913) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: IA T18031) |
| Enumeration Date | 2018-08-21 |
| Last Update Date | 2022-10-06 |