| Doctor Name: | BROCK THOMAS KOLBY |
| NPI Number: | 1114070729 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | E.D.D. |
| License Number: | LPCC142 |
| Business Practice Address: | 2 S Green St Sonora, CA - 953704618 |
| Business Phone Number: | 2095336265 |
| Business Fax Number: | |
| Mailing Address: | Po Box 1306, MURPHYS |
| State: | CA |
| Postal Code: | 952471306 |
| Phone Number: | 2097289386 |
| Fax Number: | |
| NPI Enumeration Date: | 01/18/2007 |
| NPI Last Update Date: | 05/01/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | LPCC142 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |