Individual
EMILY NICOLE BROAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW-S
Contact information
Practice address
3095 KETTERING BLVD, MORAINE, OH 45439-1983
(937) 293-8300
Mailing address
3095 KETTERING BLVD, MORAINE, OH 45439-1983
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I.2103012
OH
1041C0700X
Clinical Social Worker
Primary
I.2103012-SUPV
OH
Other
Enumeration date
12/14/2017
Last updated
02/23/2026
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