| Doctor Name: | BROOKE MALENSEK |
| NPI Number: | 1265886972 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PLPC |
| License Number: | 2016007573 |
| Business Practice Address: | 100 S Prewitt St Nevada, MO - 647721760 |
| Business Phone Number: | 4176678700 |
| Business Fax Number: | 4176677454 |
| Mailing Address: | 29114 E Justin Rd, HARWOOD |
| State: | MO |
| Postal Code: | 647509195 |
| Phone Number: | 4176841956 |
| Fax Number: | 4176677454 |
| NPI Enumeration Date: | 04/19/2016 |
| NPI Last Update Date: | 04/19/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 2016007573 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |