Individual
DEODRA BROADNAX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1451 MARINE AVE APT D, GARDENA, CA 90247-3331
(310) 991-0023
Mailing address
7857 FLORENCE AVE # 112, DOWNEY, CA 90240-3700
(310) 991-0023
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
07/27/2020
Last updated
07/27/2020
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