Provider Demographics
NPI:1932864204
Name:BROCK, ELIKA (DOT)
Entity type:Individual
Prefix:DR
First Name:ELIKA
Middle Name:
Last Name:BROCK
Suffix:
Gender:F
Credentials:DOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9015 ANDRASTE WAY
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89506-5949
Mailing Address - Country:US
Mailing Address - Phone:775-846-1307
Mailing Address - Fax:
Practice Address - Street 1:5165 SUMMIT RIDGE CT
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89523-9092
Practice Address - Country:US
Practice Address - Phone:775-787-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-02
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2861225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist