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Individual

BONNIE GAIL KESHABON BROADUS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
775 W BROAD ST STE 210, COLUMBUS, OH 43222-1471
(614) 407-1771
(614) 334-5078
Mailing address
4809 YOEST DR, WESTERVILLE, OH 43081-9644
(614) 778-4769

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
251S00000X
Community/Behavioral Health Agency

Other

Enumeration date
03/03/2025
Last updated
03/03/2025
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