| NPI | 1033577309 |
|---|---|
| Former Name | MEGAN RENAE BROCK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: KY 245273) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: KY LPCCCA00224172) |
| Enumeration Date | 2016-02-02 |
| Last Update Date | 2021-08-05 |