Kirk Douglas Brocks LMFT

NPI 1114088952 - Marriage & Family Therapist - 106H00000X

NPI Details
NPI 1114088952
Gender Male
Enumeration Date 12/13/2006
Last Updated 03/20/2015
Entity Type Individual
Active Over 10 years ago
Practice Location
2103 REDWOOD ST
SUITE 204
VALLEJO CA, 94590-3608, US
Phone (707) 642-4015
Fax (707) 642-8319
Business Location
2103 REDWOOD ST
SUITE 204
VALLEJO CA, 94590-3608, US
Phone (707) 642-4015
Fax (707) 642-8319
Toxanomy
Taxonomy Code 106H00000X
License State California
License Number MFC32561
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According to our database, Mr. Kirk Douglas Brocks LMFT NPI is 1114088952, taxonomy code is 106H00000X and license number is MFC32561, license state is located at California. Kirk Douglas Brocks LMFT physically located at 2103 Redwood St, Vallejo CA, 94590-3608. NPI Number Kirk Douglas Brocks LMFT has the Individual type.

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1114088952 NPI number is provided on an as is basis without warranty of any kind. 1114088952 is maintained by the National Plan & Provider Enumeration System. The contents of Kirk Douglas Brocks LMFT are for informational purposes only.