Individual provider · Type 1 NPI

Roosevelt Broach

Mental Health Counselor · Dallas, TX

NPI number 1083280374 Active

Practice location

12959 Jupiter Rd Ste 140
Dallas, TX 75238-3200

Mailing address

502 Point Royal Dr
Rockwall, TX 75087-8721

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800X79180 (TX)

Mental Health Counselor: Definition to come...

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About NPI 1083280374

Roosevelt Broach's National Provider Identifier is 1083280374, issued on May 27, 2021. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Dallas, TX. The record was last updated on May 27, 2021.