Individual
JANE BROUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
8495 CRATER LAKE HWY, WHITE CITY, OR 97503-3011
(541) 826-2111
(541) 830-7528
Mailing address
8495 CRATER LAKE HWY, WHITE CITY, OR 97503-3011
(541) 826-2111
(541) 830-7528
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7180
OR
1041C0700X
Clinical Social Worker
I 1600789
OH
Other
Enumeration date
01/18/2017
Last updated
01/18/2017
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