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1962070136
JIMMY DEAN BRODERICK
WINDER, GA
NPI
1962070136
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: FL 19022)
Enumeration Date
2021-06-15
Last Update Date
2021-06-15
Business Address
JIMMY DEAN BRODERICK MS, LMHC
498 VALLEY VIEW DR
WINDER, GA 30680-1421
Phone number: 386-855-5444
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Mailing Address
JIMMY DEAN BRODERICK MS, LMHC
498 VALLEY VIEW DR
WINDER, GA 30680-1421
Phone number: 386-855-5444
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