| Doctor Name: | KERI BROCKMAN |
| NPI Number: | 1518913490 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPCA |
| License Number: | 0107 |
| Business Practice Address: | 607 Old Highway 60 Hardinsburg, KY - 401432511 |
| Business Phone Number: | 2707565816 |
| Business Fax Number: | 2707565815 |
| Mailing Address: | 107 Cranes Roost Ct, ELIZABETHTOWN |
| State: | KY |
| Postal Code: | 427013650 |
| Phone Number: | 2707652605 |
| Fax Number: | 2707661222 |
| NPI Enumeration Date: | 05/25/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 0107 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |