Individual
EMILY KRISTIN BROD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
25 MIDDLE ST, PORTLAND, ME 04101-4869
(207) 712-0146
Mailing address
108 NOYES ST, APT. A, PORTLAND, ME 04103-4442
(207) 712-4905
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC11727
ME
Other
Enumeration date
05/06/2009
Last updated
05/27/2009
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