Individual
DR. MICHAEL S. BRODER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1420 LOCUST ST, 7G, PHILADELPHIA, PA 19102-4223
(215) 545-7000
(215) 545-7011
Mailing address
1420 LOCUST ST, 7G, PHILADELPHIA, PA 19102-4223
(215) 545-7000
(215) 545-7011
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS003069-L
PA
Other
Enumeration date
04/16/2007
Last updated
07/08/2007
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