| NPI | 1275151771 |
|---|---|
| Other Name | JOHNNA BROCKMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 2023011252) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MO 2020014147) |
| Enumeration Date | 2020-07-10 |
| Last Update Date | 2023-07-12 |