| Doctor Name: | MRS. ROBERTA A. BROCK |
| NPI Number: | 1336324235 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LMHC |
| License Number: | IMH5549 |
| Business Practice Address: | 2115 S Babcock St Melbourne, FL - 329015303 |
| Business Phone Number: | 3217290779 |
| Business Fax Number: | 3217290784 |
| Mailing Address: | 1948 Pineapple Ave, MELBOURNE |
| State: | FL |
| Postal Code: | 329357609 |
| Phone Number: | 3212597262 |
| Fax Number: | 3212597198 |
| NPI Enumeration Date: | 01/09/2008 |
| NPI Last Update Date: | 09/23/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | IMH5549 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |