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Individual

JERRICA LEE BRANDENBURG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPCA, CADC

Contact information

Practice address
60 MERCY CT, IRVINE, KY 40336-1331
(859) 779-1492
Mailing address
364 BROADWAY ST, IRVINE, KY 40336-1281
(859) 779-1492

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
246646
KY
101YM0800X
Mental Health Counselor
Primary
275000
KY

Other

Enumeration date
04/29/2022
Last updated
04/29/2022
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