Individual provider · Type 1 NPI
Jessica Broderick
Mental Health Counselor · Portland, OR
NPI number
1184091530
Active
Practice location
3415 SE Powell Blvd
Portland, OR 97202-3371
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | None listed |
Mental Health Counselor: Definition to come...
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- Maryjane Wilt, LPCMental Health Counselor Portland, OR NPI 1003106881
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About NPI 1184091530
Jessica Broderick's National Provider Identifier is 1184091530, issued on Sep 1, 2015. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Portland, OR. The record was last updated on Sep 1, 2015.