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1114186996
JENNIE TARA BROADHURST
THOUSAND OAKS, CA
NPI
1114186996
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2008-06-05
Last Update Date
2008-06-05
Business Address
Mrs. JENNIE TARA BROADHURST BA degree
72 MOODY CT
THOUSAND OAKS, CA 91360-6067
Phone number: 805-587-5328
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Mailing Address
Mrs. JENNIE TARA BROADHURST BA degree
72 MOODY CT COUNTY OF VENTURA CONEJO VALLEY MENTAL HEALTH
SIMI VALLEY, CA 91360
Phone number: 805-587-5328
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