Individual provider · Type 1 NPI

Marieille Jaquette Broadnax, L.P.C.

Professional Counselor · Detroit, MI

NPI number 1780795104 Active

Practice location

2051 W Grand Blvd
Detroit, MI 48208-1105

Call (313) 961-3700 Map

Fax (313) 961-3769

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500X6401008550 (MI)

Professional Counselor: Definition to come...

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About NPI 1780795104

Marieille Jaquette Broadnax, L.P.C.'s National Provider Identifier is 1780795104, issued on Aug 31, 2006. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Detroit, MI. The record was last updated on Jul 8, 2007.