Individual
CHRISTINE BROADWATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.P.C.
Contact information
Practice address
122 N ELM ST, SUITE 1015, GREENSBORO, NC 27401-2878
(336) 676-6064
(336) 676-6068
Mailing address
274 MARTY LN, LEXINGTON, NC 27292-7076
(336) 470-1668
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
852
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6103336
—
NC
Enumeration date
09/05/2006
Last updated
02/07/2012
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