Individual
DR. LAURIE BRODEUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
25 W MAIN ST, CONWAY, NH 03818-6142
(603) 447-2111
Mailing address
87 WASHINGTON ST, CONWAY, NH 03818-6044
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
604
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
225029
CIGNA
—
Enumeration date
04/03/2007
Last updated
07/08/2007
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