NPI | 1275065328 |
---|---|
Former Name | LAUREN MICHELLE BROCK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 67996) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2017-03-29 |
Last Update Date | 2023-01-30 |