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Individual

MS. CYNDI S BROADWATER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
7907 BUCK DEANS ROAD, MIDDLESEX, NC 27557
(252) 235-2161
(252) 235-2625
Mailing address
PO BOX 249, MIDDLESEX, NC 27557-0249
(252) 235-2161
(252) 235-2625

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
COO4498
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6002806
NC
Enumeration date
01/05/2007
Last updated
07/09/2007
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