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1568617413
LISA MARIE BROADHEAD
FORT CAMPBELL, KY
NPI
1568617413
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Former Name
LISA MARIE BLANCHARD
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: GA csw003927)
Enumeration Date
2008-11-19
Last Update Date
2018-07-02
Business Address
LISA MARIE BROADHEAD LCSW
BLANCHFIELD ARMY COMMUNITY HOSPITAL 650 JOEL DRIVE
FORT CAMPBELL, KY 42223
Phone number: 270-798-8601
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Mailing Address
LISA MARIE BROADHEAD LCSW
13173 AERO VISTA DR
EL PASO, TX 79908-3257
Phone number: 915-307-3941
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