SHADISHA K BENNETT BRODDE

SAINT AUGUSTINE, FL
NPI1477826022
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: FL  MH18303)
Additional Taxonomies101YP2500X Counselor, Professional
(Licence: IL  178005880)
Enumeration Date2012-02-13
Last Update Date2021-06-16
Business Address
SHADISHA K BENNETT BRODDE LPC
910 GOLDEN LAKE LOOP
SAINT AUGUSTINE, FL 32084-5877
Phone number: 478-387-5582
Mailing Address
SHADISHA K BENNETT BRODDE LPC
910 GOLDEN LAKE LOOP
SAINT AUGUSTINE, FL 32084-5877
Phone number: 478-387-5582