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1275295842
TARA BROCK
MARIETTA, GA
NPI
1275295842
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: GA RBT-21-188479)
Enumeration Date
2021-10-11
Last Update Date
2021-10-11
Business Address
TARA BROCK RBT
2121 NEWMARKET PKWY SE STE 130
MARIETTA, GA 30067-9309
Phone number: 678-486-1911
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Mailing Address
TARA BROCK RBT
3500 DEPAUW BLVD STE 3070
INDIANAPOLIS, IN 46268-6135
Phone number: 855-324-0885
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