Individual
AJANNA BROCKENBAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4 LEAWOOD DR, BRIARCLIFF MANOR, NY 10510-1316
(646) 872-4645
Mailing address
4 LEAWOOD DR, BRIARCLIFF MANOR, NY 10510-1316
(646) 872-4645
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
P116161
NY
Other
Enumeration date
07/28/2022
Last updated
07/28/2022
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