Individual
KIM RAE BROUHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1201 NE 7TH ST, SUITE C, GRANTS PASS, OR 97526-1451
(541) 955-2566
Mailing address
1448 NW HAWTHORNE AVE, GRANTS PASS, OR 97526-1214
(541) 218-1421
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1485
OR
Other
Enumeration date
03/16/2007
Last updated
07/08/2007
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