Individual
MR. RICHARD H BROACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APNP
Contact information
Practice address
309 E NORTH ST, WAUKESHA, WI 53188-3718
(414) 672-1353
(414) 385-7552
Mailing address
309 E NORTH ST, WAUKESHA, WI 53188-3718
(414) 672-1353
(414) 385-7552
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
3576125
WI
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
Primary
4270
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40995000
—
WI
Enumeration date
06/10/2006
Last updated
06/15/2016
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