Individual
MRS. ANGELA CHRISTINA BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, LMFT. MBA
Contact information
Practice address
10300 BROOKRIDGE VILLAGE BLVD, SUITE 104, LOUISVILLE, KY 40291
(502) 785-4322
(502) 785-4433
Mailing address
10300 BROOKRIDGE VILLAGE BLVD, SUITE 104, LOUISVILLE, KY 40291
(502) 785-4322
(502) 785-4433
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
3035
KY
106H00000X
Marriage & Family Therapist
KY-0617
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100068240
—
KY
Enumeration date
05/01/2007
Last updated
12/01/2020
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