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Individual

BROOKE MALENSEK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PLPC

Contact information

Practice address
100 S PREWITT ST, NEVADA, MO 64772-1760
(417) 667-8700
(417) 667-7454
Mailing address
29114 E JUSTIN RD, HARWOOD, MO 64750-9195
(417) 684-1956
(417) 667-7454

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2016007573
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1093043481
MO
05
1699756239
MO
Enumeration date
04/19/2016
Last updated
11/22/2016
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