NPI | 1942507454 |
---|---|
Former Name | BRANDY BROCK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: UT 3463453503) |
Enumeration Date | 2011-02-17 |
Last Update Date | 2025-03-21 |