Mary Ellen Broderick in Marianna - Clinical
Mary Ellen Broderick - NPI 1356484240
Mary Ellen Broderick is a Clinical in Marianna, Florida. Mary Ellen Broderick practices all healthcare services and medical treatments related to Clinical. The NPI Number for Mary Ellen Broderick is 1356484240. The last update date is 2007-07-08.
Mary Ellen Broderick's current location address is 2902 Madison St, Marianna, Florida. You can contact this provider via phone number 8504828830. The mailing address for Mary Ellen Broderick is 2902 Madison St, Marianna, Florida. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mary Ellen Broderick |
|---|---|
| Address | 2902 Madison St, Marianna, Florida |
| Phone Number | 8504828830 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | PH.D. |
NPI Number Detail
| NPI Number | 1356484240 |
|---|---|
| Provider Enumeration Date | 2007-02-14 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 2902 Madison St |
|---|---|
| City | Marianna |
| State | Florida (FL) |
| Post Code | 324463450 |
| Phone Number | 8504828830 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | PY 3181 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 75290 | FL | BCBS PSYCHOLOGIST |
Post Comment/ Review Below
What is the Mary Ellen Broderick's 1356484240?
The Mary Ellen Broderick's NPI (National Provider Identifier) Number is 1356484240. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete physical address where Mary Ellen Broderick is located?
The Mary Ellen Broderick is situated at the following address: 2902 Madison St, Marianna, FL, 324463450.
What is Mary Ellen Broderick's area of expertise and its corresponding taxonomy classification?
The Mary Ellen Broderick's field of specialization is Clinical, and it falls under the taxonomy code 103Tc0700X, which categorizes healthcare providers based on their areas of practice.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1356484240 to Mary Ellen Broderick?
The Centers for Medicare & Medicaid Services originally issued the 1356484240 to Mary Ellen Broderick on 2007-02-14.
When was the Mary Ellen Broderick's information last updated?
The Mary Ellen Broderick's information was last updated on 2007-07-08.
NPI Number: 1881683084
Address: 10400 Academy Rd Ne, Albuquerque, NM