Individual
AMY KEMP BROCKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
310 PAPER TRAIL WAY STE 106, CANTON, GA 30115-5204
(678) 880-4645
(770) 628-0046
Mailing address
310 PAPER TRAIL WAY STE 106, CANTON, GA 30115-5204
(678) 880-4645
(770) 628-0046
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC010385
GA
Other
Enumeration date
09/25/2018
Last updated
09/25/2018
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