Individual
DEBRA ANN BRODIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
300 RIVER PLACE DR STE 5350-G, DETROIT, MI 48207-4457
(313) 871-1450
(313) 468-1105
Mailing address
300 RIVER PLACE DR STE 5350-G, DETROIT, MI 48207-4457
(313) 871-1450
(313) 468-1105
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
6301006340
MI
103TC0700X
Clinical Psychologist
Primary
6301006340
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
38-3347895
BLUE CROSS BLUE SHIELD
MI
Enumeration date
10/16/2005
Last updated
09/15/2021
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