| NPI | 1548715006 |
|---|---|
| Former Name | SHANNON BROCK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA ASW84280) |
| Additional Taxonomies | 101Y00000X Counselor |
| 104100000X Social Worker | |
| Enumeration Date | 2016-08-24 |
| Last Update Date | 2019-04-02 |