Individual provider · Type 1 NPI
Jimmy Dean Broderick, MS, LMHC
Professional Counselor · Winder, GA
NPI number
1962070136
Active
Practice location
498 Valley View Dr
Winder, GA 30680-1421
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | 19022 (FL) |
Professional Counselor: Definition to come...
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About NPI 1962070136
Jimmy Dean Broderick, MS, LMHC's National Provider Identifier is 1962070136, issued on Jun 15, 2021. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Winder, GA. The record was last updated on Jun 15, 2021.