Most Relevant Information
Provider Data
| NPI Number: | 1003347501 |
| Provider Name: | KATHRYN LYNN BROCK RBT |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/26/2017 |
| Last Updated: | 04/22/2021 |
Provider Practice Location
763 J CLYDE MORRIS BLVD STE 1C
NEWPORT NEWS
VA
236011533
Practice Location Phone/Fax
| Phone: | 7575242510 |
| Fax: |
Provider Mailing Location
763 J CLYDE MORRIS BLVD STE 1C
NEWPORT NEWS
VA
236011533
Provider Mailing Phone/Fax
| Phone: | 3058469807 |
| Fax: | 3058469711 |