Individual
MELANIE ELAINE BROADWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3540 SE 15TH ST, DEL CITY, OK 73115-4906
(405) 370-0562
Mailing address
3540 SE 15TH ST, DEL CITY, OK 73115-4906
(405) 370-0562
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/18/2012
Last updated
05/18/2012
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