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1720199540
CLARA SUSANNE BRODERICK
PROVO, UT
NPI
1720199540
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
104100000X Social Worker
(Licence: UT 5337611 3503)
Enumeration Date
2006-08-31
Last Update Date
2007-07-08
Business Address
CLARA SUSANNE BRODERICK SSW
750 NORTH 200 WEST
PROVO, UT 84601
Phone number: 801-373-4760
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Mailing Address
CLARA SUSANNE BRODERICK SSW
750 NORTH 200 WEST
PROVO, UT 84601
Phone number: 801-373-4760
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