Individual
SHERRY DIANE BROADWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
517B GREEN STREET, GAINESVILLE, GA 30501
(706) 949-3131
Mailing address
PO BOX 716, CLARKESVILLE, GA 30523-0012
(706) 949-3131
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
GA
Other
Enumeration date
11/04/2013
Last updated
09/21/2020
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