Individual
JESSICA LEE BROCKMEIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
283 US HIGHWAY 60 W, REPUBLIC, MO 65738-1432
(172) 481-7484
(417) 200-2686
Mailing address
283 US HIGHWAY 60 W, REPUBLIC, MO 65738-1432
(417) 248-1748
(417) 200-2686
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
2015006040
MO
101YP2500X
Professional Counselor
Primary
2015006040
MO
Other
Enumeration date
03/20/2015
Last updated
06/06/2021
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