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Individual

DOREIAN M BROADEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPMHP, LPMSW

Contact information

Practice address
7215 ONTARIO ST, OMAHA, NE 68124-3574
(531) 999-7120
Mailing address
1650 S TOPAZ WAY, MERIDIAN, ID 83642-4474
(208) 605-7070

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPMHP-13296
NE
104100000X
Social Worker
LPMSW-7823
NE

Other

Enumeration date
03/30/2023
Last updated
03/30/2023
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