Provider Information for 1790937555
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KARLA BROCKMAN LCPC
Sex: Female
NPI: 1790937555
Last Updated: 2008-10-10
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1790937555 | ||||||||
| Enumeration Date | 2008-10-10 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 500 LIMIT ST LEAVENWORTH, KS 66048-4435 United States Phone: 913-682-5118 | Fax:913-682-4664 | ||||||||
| Primary Practice Address | 1301 N 2ND ST ATCHISON, KS 66002-1297 United States Phone: 913-367-1593 | Fax:913-367-1627 | ||||||||
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