Individual
CAROL ANN BRODERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
411 CARDINAL WAY, SAN ANTONIO, TX 78253-5614
(210) 277-7470
(210) 706-7466
Mailing address
411 CARDINAL WAY, SAN ANTONIO, TX 78253-5614
(210) 277-7470
(210) 706-7466
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
17673
TX
Other
Enumeration date
11/19/2008
Last updated
11/19/2008
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