Individual
MRS. KATESHA SHANEE BROADUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, BC-TMH
Contact information
Practice address
110 COLISEUM CROSSING #5050, HAMPTON, VA 23666
(757) 785-4424
Mailing address
110 COLISEUM CROSSING, #5050, HAMPTON, VA 23666-5971
(757) 785-4424
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904010149
VA
1041C0700X
Clinical Social Worker
P009061
NC
Other
Enumeration date
09/04/2014
Last updated
11/27/2023
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