Organization
BROKEN ROADS COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACY BRANDON LCSW (OWNER)
(386) 249-5976
Entity
Organization
Contact information
Practice address
3519 168TH ST, WELLBORN, FL 32094-3017
(386) 249-5976
Mailing address
3519 168TH ST, WELLBORN, FL 32094-3017
(386) 249-5976
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
05/30/2024
Last updated
05/30/2024
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