Individual
JENNA ROSE BROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, BCBA, LBA
Contact information
Practice address
2537 LARKIN RD, LEXINGTON, KY 40503-3201
(859) 406-5699
Mailing address
2537 LARKIN RD, LEXINGTON, KY 40503-3201
(859) 406-5699
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
300329
KY
106S00000X
Behavior Technician
RBT-22-212220
KY
Other
Enumeration date
09/19/2022
Last updated
07/14/2025
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