Brock, Martha Wiley
Brock, Martha Wiley is an sole proprietor health care provider with primary practice located at 100 N Central Expy Suite 614, Richardson TX 75080-5332. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Brock, Martha Wiley can be contacted via phone (972) 889-2487.Contact Information
Primary practice address
100 N Central Expy Suite 614
Richardson TX 75080-5332
Phone: (972) 889-2487
Fax: (974) 889-2482
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 11428 | Texas |
| Behavioral Health & Social Service Providers / Marriage & Family Therapist | 106H00000X | 0003444 | Texas |
Profile Details
| NPI number | 1427068808 |
|---|---|
| LBN Legal business name | Brock, Martha Wiley |
| Credentials | LPC, LMFT |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 9th, 2006 |
| Last updated | Jul 9th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1427068808 | NPPES |
| Texas | Other | 0003849LC | BCBS |
| Texas | Other | 126325 | BCBS |
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