Individual
JOANNA R BRODERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
701 MARKET ST STE 110, SAINT LOUIS, MO 63101-1824
(417) 221-6655
(635) 217-9140
Mailing address
2546 S BRANDON AVE, SPRINGFIELD, MO 65809-3503
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2021030516
MO
101YM0800X
Mental Health Counselor
C8553
OR
101YP2500X
Professional Counselor
2021030516
MO
Other
Enumeration date
06/18/2021
Last updated
06/05/2025
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