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1720509813
MIA ELISE BROBERG
SALEM, OR
NPI
1720509813
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2017-06-29
Last Update Date
2017-06-29
Business Address
MIA ELISE BROBERG
1595 COTTAGE ST NE
SALEM, OR 97301
Phone number: 503-897-1289
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Mailing Address
MIA ELISE BROBERG
1715 CHEMAWA RD. NE
KEIZER, OR 97303
Phone number: 503-383-8061
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