Individual
DR. DEBRA JEAN BRODERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PYS.D.
Contact information
Practice address
357 KELLOGG BLVD E, SAINT PAUL, MN 55101-1411
(651) 295-1422
Mailing address
1434 SIMPSON ST, SAINT PAUL, MN 55108-2440
(651) 645-3998
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
4744
MN
Other
Enumeration date
02/22/2007
Last updated
07/08/2007
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