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1407322589
SEIJI BROCK
MERIDIAN, ID
NPI
1407322589
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: ID 6970)
Enumeration Date
2018-10-16
Last Update Date
2018-10-16
Business Address
SEIJI BROCK
1799 N LAKES PL
MERIDIAN, ID 83646-1833
Phone number: 208-888-5905
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Mailing Address
SEIJI BROCK
4552 N CITRUS AVE
BOISE, ID 83713-9556
Phone number: 208-861-0233
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