Individual provider · Type 1 NPI
Philip Broesamle
Addiction (Substance Use Disorder) Counselor · Shady Cove, OR
NPI number
1427444264
Active
Practice location
60 Mallory Ln.
Shady Cove, OR 97539
Mailing address
PO Box 323
Shady Cove, OR 97539
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | None listed |
Addiction (Substance Use Disorder) Counselor: Definition to come...
About NPI 1427444264
Philip Broesamle's National Provider Identifier is 1427444264, issued on Apr 8, 2015. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Shady Cove, OR. The record was last updated on Apr 8, 2015.